Healthcare Provider Details

I. General information

NPI: 1982336129
Provider Name (Legal Business Name): KIRK HUANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 N POINT DR STE 200
CLARION PA
16214-3873
US

IV. Provider business mailing address

330 N POINT DR STE 200
CLARION PA
16214-3873
US

V. Phone/Fax

Practice location:
  • Phone: 833-684-1889
  • Fax: 814-226-4505
Mailing address:
  • Phone: 833-684-1889
  • Fax: 814-226-4505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOT021790
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: