Healthcare Provider Details

I. General information

NPI: 1447438874
Provider Name (Legal Business Name): YOUNG WON KANG M.D. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 03/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4855 RIVER GREEN PKWY #140
DULUTH GA
30096-8336
US

IV. Provider business mailing address

4855 RIVER GREEN PKWY #140
DULUTH GA
30096-8336
US

V. Phone/Fax

Practice location:
  • Phone: 678-417-0077
  • Fax: 678-417-0337
Mailing address:
  • Phone: 678-417-0077
  • Fax: 678-417-0337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. YOUNG W KANG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 678-417-0077