Provider Demographics
NPI:1992741938
Name:YAN, JIONG (MD)
Entity type:Individual
Prefix:
First Name:JIONG
Middle Name:
Last Name:YAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JLONG
Other - Middle Name:
Other - Last Name:FREEMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1365B CLIFTON RD NE
Mailing Address - Street 2:BUILDING B RM 2401
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322
Mailing Address - Country:US
Mailing Address - Phone:404-778-4120
Mailing Address - Fax:404-778-4380
Practice Address - Street 1:1365B CLIFTON RD NE
Practice Address - Street 2:BUILDING B RM 2401
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322
Practice Address - Country:US
Practice Address - Phone:404-778-4120
Practice Address - Fax:404-778-4380
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048044207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology