Healthcare Provider Details

I. General information

NPI: 1053932723
Provider Name (Legal Business Name): HENRY YAO ZHANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3073 PANTHERSVILLE RD
DECATUR GA
30034-3800
US

IV. Provider business mailing address

3073 PANTHERSVILLE RD
DECATUR GA
30034-3800
US

V. Phone/Fax

Practice location:
  • Phone: 404-243-2100
  • Fax:
Mailing address:
  • Phone: 404-243-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number125.076121
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number99553
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: