Healthcare Provider Details

I. General information

NPI: 1629224050
Provider Name (Legal Business Name): HYEYOUNG ERIN JEUN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HYE YOUNG JEUN M.D.

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL DR
COLUMBIA MO
65212-0001
US

IV. Provider business mailing address

PO BOX 7687
COLUMBIA MO
65205-7687
US

V. Phone/Fax

Practice location:
  • Phone: 573-882-8091
  • Fax: 573-884-1902
Mailing address:
  • Phone: 573-882-2259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2012036270
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License Number277217
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: