Provider Demographics
NPI:1528021078
Name:KIANG, HENRY N (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:N
Last Name:KIANG
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 1:73 SIPPRELLE DR
Mailing Address - Street 2:
Mailing Address - City:PARACHUTE
Mailing Address - State:CO
Mailing Address - Zip Code:81635-9213
Mailing Address - Country:US
Mailing Address - Phone:970-285-7046
Mailing Address - Fax:970-285-6064
Practice Address - Street 1:73 SIPPRELLE DR
Practice Address - Street 2:
Practice Address - City:PARACHUTE
Practice Address - State:CO
Practice Address - Zip Code:81635-9213
Practice Address - Country:US
Practice Address - Phone:970-285-7046
Practice Address - Fax:970-285-6064
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34019207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO840513889015OtherRMHP
CO01340199Medicaid
COKI39565OtherBCBS
COC802413Medicare PIN
CO01340199Medicaid