Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 34506 | OH |
N | 208600000X | Surgeon | 34506 | OH |
N | 208D00000X | General Practice Physician | 34506 | OH |
NPI | 1033103148 |
---|---|
Provider Name | Dr. John Joonpyo Hong |
First Address | Brookpark, OH 44142-2345 |
Second Address | Brookpark, OH 44142-2345 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0205352 | (05) | OH |
C00980 | (02) |