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General NPI Number Information
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NPI Number | 1356664064
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Entity Type | Organization
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Legal Business Name | H. KELL YANG MD PC
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | 201 W BROADWAY BLDG. 4
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City | COLUMBIA
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State | MO
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Zip | 65203-3842
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Country | US
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Telephone | 573-441-7070
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Fax | 573-441-2288
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Provider Business Mailing Address
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Address Line | 201 W BROADWAY BLDG. 4
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City | COLUMBIA
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State | MO
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Zip | 65203-3842
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Country | US
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Telephone | 573-441-7070
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Fax | 573-441-2288
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Authorized Official
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Title or Position | OWNER
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Name | HENRY KELL YANG
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Credential | M.D.
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Telephone | 573-441-7070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MDR7A95
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License Number State | MO
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