Provider Demographics
NPI:1770505612
Name:YANG, HARRISON YN (MD, FACP, FACC)
Entity Type:Individual
Prefix:DR
First Name:HARRISON
Middle Name:YN
Last Name:YANG
Suffix:
Gender:M
Credentials:MD, FACP, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 MCARTHUR ST STE D
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-2365
Mailing Address - Country:US
Mailing Address - Phone:931-728-1107
Mailing Address - Fax:931-728-9540
Practice Address - Street 1:845 MCARTHUR ST STE D
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-2365
Practice Address - Country:US
Practice Address - Phone:931-728-1107
Practice Address - Fax:931-728-9540
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD10651207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3163647Medicaid
B03020Medicare UPIN
3163647Medicare ID - Type Unspecified