Provider Demographics
NPI:1023004272
Name:YOON, YOUNGSOOK (MD)
Entity Type:Individual
Prefix:DR
First Name:YOUNGSOOK
Middle Name:
Last Name:YOON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:YOUNG
Other - Middle Name:SOOK
Other - Last Name:YOON-KRAWCZYK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3355 GLENDALE AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2426
Mailing Address - Country:US
Mailing Address - Phone:419-720-0317
Mailing Address - Fax:419-720-0319
Practice Address - Street 1:1000 REGENCY CT
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3091
Practice Address - Country:US
Practice Address - Phone:419-720-0317
Practice Address - Fax:419-720-0319
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35078566207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2189840Medicaid
D38115Medicare UPIN
OHYO4029865Medicare ID - Type Unspecified