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General NPI Number Information
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NPI Number | 1245200476
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Entity Type | Individual
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Provider Name | REX T YANG M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 01/06/2013
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Provider Practice Location Address
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Address Line | 2122 BLAZING STAR DR
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City | TIPP CITY
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State | OH
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Zip | 45371-8377
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Country | US
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Telephone | 773-354-3454
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Fax |
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Provider Business Mailing Address
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Address Line | 2122 BLAZING STAR DR
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City | TIPP CITY
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State | OH
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Zip | 45371-8377
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Country | US
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Telephone | 773-354-3454
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 036114566
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 35.077525
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License Number State | OH
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