Healthcare Provider Details

I. General information

NPI: 1972647659
Provider Name (Legal Business Name): YING AMORN, M.D., F.A.C.G., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 07/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

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: DR. YING AMORN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 330-726-0131