Healthcare Provider Details

I. General information

NPI: 1518951466
Provider Name (Legal Business Name): YING K AMORN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date: 03/25/2006
Reactivation Date: 03/31/2006

III. Provider practice location address

1220 BOARDMAN CANFIELD RD
YOUNGSTOWN OH
44512-4003
US

IV. Provider business mailing address

1220 BOARDMAN CANFIELD RD
YOUNGSTOWN OH
44512-4003
US

V. Phone/Fax

Practice location:
  • Phone: 330-726-0131
  • Fax: 330-726-2571
Mailing address:
  • Phone: 330-726-0131
  • Fax: 330-726-2571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35100237
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: