Healthcare Provider Details

I. General information

NPI: 1669656146
Provider Name (Legal Business Name): DR. YUNG, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2007
Last Update Date: 12/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 UNIVERSITY BLVD SUITE 30005
INDIANAPOLIS IN
46202-5149
US

IV. Provider business mailing address

550 UNIVERSITY BLVD SUITE 3080
INDIANAPOLIS IN
46202-5149
US

V. Phone/Fax

Practice location:
  • Phone: 317-274-8937
  • Fax: 317-274-2727
Mailing address:
  • Phone: 317-274-1034
  • Fax: 317-274-3265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. CHI -WAH YUNG
Title or Position: OWNER
Credential: MD
Phone: 317-274-8937