Healthcare Provider Details

I. General information

NPI: 1043461957
Provider Name (Legal Business Name): JAMES B YOON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2008
Last Update Date: 10/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1019 FARMINGTON AVE
BRISTOL CT
06010-3955
US

IV. Provider business mailing address

1019 FARMINGTON AVE
BRISTOL CT
06010-3955
US

V. Phone/Fax

Practice location:
  • Phone: 860-585-9765
  • Fax: 860-585-9765
Mailing address:
  • Phone: 860-585-9765
  • Fax: 860-585-9765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number020630
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: