Healthcare Provider Details

I. General information

NPI: 1649761701
Provider Name (Legal Business Name): ZHIXING YAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2018
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1337C N RACE ST
GLASGOW KY
42141-3427
US

IV. Provider business mailing address

1337C N RACE ST
GLASGOW KY
42141-3427
US

V. Phone/Fax

Practice location:
  • Phone: 270-659-5622
  • Fax: 270-659-5686
Mailing address:
  • Phone: 270-659-5622
  • Fax: 270-659-5686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number57976
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number57976
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: