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Individual

DOO YEON KANG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
206 MAPLE DR, VIDALIA, GA 30474
(912) 537-2020
(912) 537-7935
Mailing address
206 MAPLE DR, VIDALIA, GA 30474-8907
(912) 537-2020
(912) 537-7935

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002744
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003135309A
GA
05
003135309B
GA
05
003135309C
GA
Enumeration date
08/31/2012
Last updated
01/16/2019
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