Healthcare Provider Details

I. General information

NPI: 1205340494
Provider Name (Legal Business Name): HEALTH EXPRESS URGENT CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2017
Last Update Date: 04/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 DOG PATCH TRADING CENTER SUITE-2
LONDON KY
40741-0000
US

IV. Provider business mailing address

94 DOG PATCH TRADING CENTER SUITE-2
LONDON KY
40741-0000
US

V. Phone/Fax

Practice location:
  • Phone: 606-877-1352
  • Fax: 606-877-1356
Mailing address:
  • Phone: 606-877-1352
  • Fax: 606-877-1356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number1000633
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. EMMANUEL YUMANG
Title or Position: PRESIDENT OWNER
Credential: MD
Phone: 606-887-1352