Healthcare Provider Details

I. General information

NPI: 1912054735
Provider Name (Legal Business Name): EDDY SHIH-HSIN YANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SHIH-HSIN YANG MD

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 01/27/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-1801
US

IV. Provider business mailing address

1717 6TH AVE S
BIRMINGHAM AL
35233-1801
US

V. Phone/Fax

Practice location:
  • Phone: 859-257-7618
  • Fax: 859-257-4060
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number30284
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberTP328
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: