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Individual

DR. IAN KONRAD KANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7777 HENNESSY BLVD, SUITE 502, BATON ROUGE, LA 70808-4300
(225) 765-2054
(225) 765-3342
Mailing address
7777 HENNESSY BLVD, SUITE 502, BATON ROUGE, LA 70808-4300
(225) 765-2054
(225) 765-3342

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036110845
IL
2080P0206X
Pediatric Gastroenterology Physician
Primary
MD.203969
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2113461
LA
Enumeration date
10/18/2006
Last updated
03/03/2011
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