Provider Demographics
NPI:1275945545
Name:KANG, HO-AN (DO)
Entity Type:Individual
Prefix:
First Name:HO-AN
Middle Name:
Last Name:KANG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5969 E BROAD ST STE 403
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1540
Mailing Address - Country:US
Mailing Address - Phone:614-234-7535
Mailing Address - Fax:614-234-6511
Practice Address - Street 1:5969 E BROAD ST STE 403
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1540
Practice Address - Country:US
Practice Address - Phone:614-234-7535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-21
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.012851207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine