Provider Demographics
NPI:1093772493
Name:HWANG, YUNG H (MD)
Entity Type:Individual
Prefix:DR
First Name:YUNG
Middle Name:H
Last Name:HWANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 E AIRPORT DR
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-3402
Mailing Address - Country:US
Mailing Address - Phone:417-237-0604
Mailing Address - Fax:
Practice Address - Street 1:1450 E. KEARNEY
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65803
Practice Address - Country:US
Practice Address - Phone:417-831-0200
Practice Address - Fax:417-831-0203
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO431036529208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200596518Medicaid
MO21316OtherBLUE CROSS BLUE SHIELD
MO21316OtherBCBS
MOA11920Medicare UPIN
MO000009503Medicare PIN