Individual provider Active NPI

Hak Sok Seo, MD

  • Internal Medicine Physician
  • Dayton, TN
National Provider Identifier
1043471238
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
47543 Issued in TN
Practice address
188 16TH Ave
Suite 107
Dayton, TN 37321-1036
Phone
(423) 775-6933
Fax
(423) 775-3372
NPI assigned
Jun 19, 2008
Last updated
Jun 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 002990 GA
Internal Medicine Physician 207R00000X 47543 TN Primary

Addresses

Primary practice location

188 16TH Ave
Suite 107
Dayton, TN 37321-1036

Mailing address

188 16TH Ave
Suite 107
Dayton, TN 37321-1036
Phone (423) 775-6933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110809000093 TN Practitioner - Internal Medicine 4082883079 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dayton Internal Medicine, PLLCGroup PAC ID 6901075993, 3 clinicians

Practice addresses (Care Compare)

118 16TH Ave
Suite 107
Dayton, TN 37321-1037

188 16TH Ave
Suite 107
Dayton, TN 37321-1037
Phone (423) 775-6933

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
002990GAMDInternal Medicine Physician
47543TNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Physician Services PC Internal Medicine CurrentSince Nov 1, 2012 Accepting new patients
Dayton Internal Medicine, PLLC Internal Medicine CurrentSince Aug 1, 2011 Accepting new patients

Locations

2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000

188 16th Ave
Ste 107
Dayton, TN 37321
Phone (423) 775-6933

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1043471238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 16TH AVE",
            "address_2": "SUITE 107",
            "city": "DAYTON",
            "state": "TN",
            "postal_code": "373211036",
            "telephone_number": "423-775-6933",
            "fax_number": "423-775-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 16TH AVE",
            "address_2": "SUITE 107",
            "city": "DAYTON",
            "state": "TN",
            "postal_code": "373211036",
            "telephone_number": "423-775-6933",
            "fax_number": "423-775-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEO",
        "first_name": "HAK",
        "middle_name": "SOK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-19",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "002990",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "47543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, TN

Sources for this page

Verify at the official NPI Registry.