Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 52050 | GA |
NPI | 1003808593 |
---|---|
Provider Name | Dr. Young H An |
First Address | Fayetteville, GA 30214-4565 |
Second Address | Fayetteville, GA 30214-4565 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2005 |
Last Update Date | 09/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12308453 | MULTIPLAN (01) | GA |
52887621 | BCBS OF GEORGIA (01) | GA |
6376 | KAISER PERMANENTE (01) | GA |
7388707 | AETNA (01) | GA |
8711892 | CIGNA (01) | GA |
89124771A | (05) | GA |
89124771B | (05) | GA |
89124771C | (05) | GA |