Provider Demographics
NPI:1992709471
Name:KANG, HYUNG-CHIL (MD)
Entity type:Individual
Prefix:
First Name:HYUNG-CHIL
Middle Name:
Last Name:KANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 UHRMANN RD
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-1123
Mailing Address - Country:US
Mailing Address - Phone:541-274-4171
Mailing Address - Fax:541-274-4174
Practice Address - Street 1:2610 UHRMANN RD
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-1123
Practice Address - Country:US
Practice Address - Phone:541-274-4171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01058135A207RH0003X, 207RX0202X
WI84386207RH0003X
MI4301082714207RH0003X
ORMD208228207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100226095Medicaid
IN200464630AMedicaid
MI10-4539520Medicaid
MIHK082714OtherBLUE CROSS BLUE SHEILD MI
MI10-4539520Medicaid
IN216950MMedicare PIN