Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 36-00-3307 | OH |
Y | 222Z00000X | Podiatrist | 36-00-3307 | OH |
NPI | 1063411338 |
---|---|
Provider Name | Dr. Gordon Hoy Yun |
First Address | Edgewood, KY 41017-3405 |
Second Address | Cincinnati, OH 45245-5136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 25/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U86909 | (02) |