Provider Demographics
NPI:1841499191
Name:YOON, HEESUK RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:HEESUK
Middle Name:RICHARD
Last Name:YOON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2 PROFESSIONAL PARK DR
Mailing Address - Street 2:SUITE 11
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-6583
Mailing Address - Country:US
Mailing Address - Phone:423-434-0642
Mailing Address - Fax:423-434-9963
Practice Address - Street 1:2428 KNOB CREEK RD STE 201
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2396
Practice Address - Country:US
Practice Address - Phone:423-282-5054
Practice Address - Fax:423-283-0516
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4448912086S0129X
TN495862086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery