Provider Demographics
NPI:1588833727
Name:JEONG, JINYOUNG (MD,PHD)
Entity Type:Individual
Prefix:DR
First Name:JINYOUNG
Middle Name:
Last Name:JEONG
Suffix:
Gender:M
Credentials:MD,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26300 SEVILLE DR APT 111
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-7595
Mailing Address - Country:US
Mailing Address - Phone:216-269-3488
Mailing Address - Fax:
Practice Address - Street 1:26300 SEVILLE DR APT 111
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-7595
Practice Address - Country:US
Practice Address - Phone:216-269-3488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.011193207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery