Healthcare Provider Details

I. General information

NPI: 1588995765
Provider Name (Legal Business Name): YUNG H. HWANG, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2010
Last Update Date: 01/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 E AIRPORT DR
CARTHAGE MO
64836-3402
US

IV. Provider business mailing address

327 E AIRPORT DR
CARTHAGE MO
64836-3402
US

V. Phone/Fax

Practice location:
  • Phone: 417-358-4515
  • Fax: 417-358-3663
Mailing address:
  • Phone: 417-358-4515
  • Fax: 417-358-3663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License Number3276
License Number StateMO

VIII. Authorized Official

Name: MRS. GINGER LEA HANSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 417-831-0200