Provider Demographics
NPI:1699035717
Name:YOO, ROBERT DUKJUN (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DUKJUN
Last Name:YOO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2910 N 3RD AVE # 470
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4434
Mailing Address - Country:US
Mailing Address - Phone:602-406-6387
Mailing Address - Fax:602-406-2931
Practice Address - Street 1:2910 N 3RD AVE # 470
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4434
Practice Address - Country:US
Practice Address - Phone:602-406-6387
Practice Address - Fax:602-406-2931
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7516207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ380471Medicaid