1962428870 NPI number — DR. XIANGDONG YOU

Table of content: DR. XIANGDONG YOU (NPI 1962428870)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962428870 NPI number — DR. XIANGDONG YOU

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YOU
Provider First Name:
XIANGDONG
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
N/A
Provider Other First Name:
N/A
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1962428870
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/09/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6025 PROFESSIONAL PKWY
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
DOUGLASVILLE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30134-5609
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-489-5000
Provider Business Mailing Address Fax Number:
770-489-0305

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6025 PROFESSIONAL PKWY
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
DOUGLASVILLE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30134-5609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-489-5000
Provider Business Practice Location Address Fax Number:
770-489-0305
Provider Enumeration Date:
07/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  050465 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000934007E , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 04-03355 . This is a "UHC" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 201354919 . This is a "PHCS" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 201354919 . This is a "MULTIPLAN" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 21232609899 . This is a "BEECH STREET" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 201354919 . This is a "COVENTRY" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 6104 . This is a "KAISER" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 7676325 . This is a "AETNA" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 320129 . This is a "WELLCARE OF GEORGIA" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 52895315 . This is a "BCBS" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: P00242355 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 201354919 . This is a "HUMANA" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 201354919 . This is a "SOUTHCARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 3462913 . This is a "CIGNA" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 782253003 . This is a "GREAT-WEST" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 201354919 . This is a "HUMANA GOLD CHOICE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 2089568 . This is a "FIRST HEALTHCARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com