Provider Demographics
NPI:1972647659
Name:YING AMORN, M.D., F.A.C.G., INC.
Entity Type:Organization
Organization Name:YING AMORN, M.D., F.A.C.G., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YING
Authorized Official - Middle Name:
Authorized Official - Last Name:AMORN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-726-0131
Mailing Address - Street 1:1220 BOARDMAN CANFIELD RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4003
Mailing Address - Country:US
Mailing Address - Phone:330-726-0131
Mailing Address - Fax:330-726-2571
Practice Address - Street 1:1220 BOARDMAN CANFIELD RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-4003
Practice Address - Country:US
Practice Address - Phone:330-726-0131
Practice Address - Fax:330-726-2571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35100237207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000130030OtherANTHEM
OH0346085Medicaid
OHA75861Medicare UPIN
OH0346085Medicaid