Provider Demographics
NPI:1194790691
Name:WANG, KUO-YING JOCELYN
Entity type:Individual
Prefix:DR
First Name:KUO-YING
Middle Name:JOCELYN
Last Name:WANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 636799
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6799
Mailing Address - Country:US
Mailing Address - Phone:513-853-4749
Mailing Address - Fax:513-852-8525
Practice Address - Street 1:10495 MONTGOMERY RD
Practice Address - Street 2:SUITE 17
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-4468
Practice Address - Country:US
Practice Address - Phone:513-984-2775
Practice Address - Fax:513-984-5764
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35067518207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200314690Medicaid
OH2022484Medicaid
OH110221144OtherRR MEDICARE
IN200314690Medicaid
OHG50593Medicare UPIN