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NPI Code Detail

MEDICARE: DR. JOON S AHN M.D.

MEDICARE: DR. JOON S AHN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XS0106XOrthopaedic Hand Surgery Physician036104840IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083681027
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOON S AHN M.D.
Provider Business Mailing Address
First Line : 4121 VETERANS MEMORIAL DR
Second Line :
City : MOUNT VERNON
State : IL
Zip : 62864-6262
Country : US
Telephone Number : 618-242-3778
Fax Number : 618-242-2551
Provider Business Practice Location Address
First Line : 4121 VETERANS MEMORIAL DR
Second Line :
City : MOUNT VERNON
State : IL
Zip : 62864-6262
Country : US
Telephone Number : 618-242-3778
Fax Number : 618-242-2551
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2006
Last Update Date : 07/09/2007

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Directions to “ DR. JOON S AHN M.D.” Practice Location

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