Provider Demographics
NPI:1861424293
Name:KANG, YOUNG HEE (MD)
Entity type:Individual
Prefix:DR
First Name:YOUNG
Middle Name:HEE
Last Name:KANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:107 S ELMS ST
Mailing Address - Street 2:
Mailing Address - City:WELSH
Mailing Address - State:LA
Mailing Address - Zip Code:70591-4211
Mailing Address - Country:US
Mailing Address - Phone:337-734-4730
Mailing Address - Fax:337-734-4730
Practice Address - Street 1:107 S ELMS ST
Practice Address - Street 2:
Practice Address - City:WELSH
Practice Address - State:LA
Practice Address - Zip Code:70591-4211
Practice Address - Country:US
Practice Address - Phone:337-734-4730
Practice Address - Fax:337-734-4730
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA05031R207Q00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1300691Medicaid
LA1300691Medicaid
LA5L584Medicare ID - Type Unspecified