Individual
NIKKI DANIELLE YING TANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2924 SISKIYOU BLVD STE 200, MEDFORD, OR 97504-6462
(541) 200-2777
(541) 214-2575
Mailing address
2924 SISKIYOU BLVD STE 200, MEDFORD, OR 97504-6462
(541) 200-2777
(541) 214-2575
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
MD195049
OR
207ND0101X
MOHS-Micrographic Surgery Physician
2862881
NY
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
MD195049
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114347600
—
MD
05
—
500766374
—
OR
Enumeration date
06/02/2011
Last updated
01/02/2021
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