Individual
KEN T. YANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
403 FAIRVIEW ST, CLINTON, NC 28328-2399
(910) 592-6011
(910) 592-0811
Mailing address
403 FAIRVIEW ST, CLINTON, NC 28328-2399
(109) 592-6011
(910) 592-0814
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
98-00430
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00385186
—
NC
01
—
0138714
UNITED HEALTHCARE
NC
01
—
1131X
NC BLUE CROSS BLUE SHIELD
NC
01
—
560955090K
CIGNA
NC
01
—
7664347
AETNA
NC
01
—
79701
MEDCOST
NC
Enumeration date
06/28/2006
Last updated
05/22/2020
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