Provider Demographics
NPI:1588995765
Name:YUNG H. HWANG, INC
Entity type:Organization
Organization Name:YUNG H. HWANG, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-831-0200
Mailing Address - Street 1:327 E AIRPORT DR
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-3402
Mailing Address - Country:US
Mailing Address - Phone:417-358-4515
Mailing Address - Fax:417-358-3663
Practice Address - Street 1:327 E AIRPORT DR
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-3402
Practice Address - Country:US
Practice Address - Phone:417-358-4515
Practice Address - Fax:417-358-3663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO3276170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical GeneticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO473640OtherBCBS PIN
MO200596518Medicaid
MO000009503Medicare PIN
MO200596518Medicaid