Healthcare Provider Details

I. General information

NPI: 1326046798
Provider Name (Legal Business Name): ERIC JAMES YOON DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 09/29/2026
Certification Date:
Deactivation Date: 09/21/2005
Reactivation Date: 10/27/2006

III. Provider practice location address

95 EAST MAIN STREET
WEST JEFFERSON OH
43162
US

IV. Provider business mailing address

95 E MAIN ST
WEST JEFFERSON OH
43162-1205
US

V. Phone/Fax

Practice location:
  • Phone: 614-879-7100
  • Fax: 614-879-7151
Mailing address:
  • Phone: 614-879-7100
  • Fax: 614-879-7151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP05791
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberNP05791
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: