Provider Demographics
NPI:1134819972
Name:YANG, ERIC
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8931 S YALE AVE STE L
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-3531
Mailing Address - Country:US
Mailing Address - Phone:918-600-0890
Mailing Address - Fax:918-600-0891
Practice Address - Street 1:8931 S YALE AVE STE L
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-3531
Practice Address - Country:US
Practice Address - Phone:918-600-0890
Practice Address - Fax:918-600-0891
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4557111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor