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General NPI Number Information
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NPI Number | 1932138062
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Entity Type | Organization
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Legal Business Name | Y.C. AHN, M.D., P.L.L.C.
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1800 W 1ST ST SUITE 1
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City | ELK CITY
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State | OK
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Zip | 73644-3133
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Country | US
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Telephone | 580-243-0100
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Fax | 580-243-0807
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Provider Business Mailing Address
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Address Line | 1800 W 1ST ST SUITE 1
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City | ELK CITY
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State | OK
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Zip | 73644-3133
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Country | US
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Telephone | 580-243-0100
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Fax | 580-243-0807
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Authorized Official
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Title or Position | PHYSICIAN/CEO
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Name | DR. YOO CHUL AHN
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Credential | M.D.
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Telephone | 580-243-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 11651
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License Number State | OK
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