Provider Demographics
NPI:1669473468
Name:YUN, KIRO JOHN (MD)
Entity Type:Individual
Prefix:
First Name:KIRO
Middle Name:JOHN
Last Name:YUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:906 WOODLAND DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2752
Mailing Address - Country:US
Mailing Address - Phone:270-765-5127
Mailing Address - Fax:270-765-2653
Practice Address - Street 1:101 FINANCIAL PL STE 104
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-8481
Practice Address - Country:US
Practice Address - Phone:270-765-5127
Practice Address - Fax:270-765-5337
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY28644207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64286446Medicaid
KY64286446Medicaid
1453902Medicare ID - Type Unspecified