Provider Demographics
NPI:1336217926
Name:AHN SUNG, YOO KYUNG (MD)
Entity Type:Individual
Prefix:MRS
First Name:YOO
Middle Name:KYUNG
Last Name:AHN SUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:YOO
Other - Middle Name:KYUNG
Other - Last Name:AHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6685 CLEARBROOK DRIVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-3944
Mailing Address - Country:US
Mailing Address - Phone:615-356-8384
Mailing Address - Fax:615-356-8384
Practice Address - Street 1:2851 LOGAN STREET
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-2409
Practice Address - Country:US
Practice Address - Phone:615-781-2333
Practice Address - Fax:615-356-8384
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000010960208D00000X
CAA34687208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
B58988Medicare UPIN