Healthcare Provider Details

I. General information

NPI: 1821203233
Provider Name (Legal Business Name): SONG ZANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 E 32ND ST
JOPLIN MO
64804-2878
US

IV. Provider business mailing address

PO BOX 3810
JOPLIN MO
64803-3810
US

V. Phone/Fax

Practice location:
  • Phone: 417-347-8490
  • Fax: 417-347-5515
Mailing address:
  • Phone: 417-347-8400
  • Fax: 417-347-5818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number2025052143
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: