MEDICARE: DR. JASON HEUNGNO YOON 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
1	207Q00000X	Family Medicine Physician	7384	DC

Other Identifiers

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

General Provider Information

NPI Number	:	1821178757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON HEUNGNO YOON M.D.

Provider Business Mailing Address
First Line	:	2345 MARTIN LUTHER KING JR AVE SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-5821
Country	:	US
Telephone Number	:	202-678-4940
Fax Number	:	202-678-9703

Provider Business Practice Location Address
First Line	:	2345 MARTIN LUTHER KING JUNIOR AVENUE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-7007
Country	:	US
Telephone Number	:	202-678-4940
Fax Number	:	202-678-9703

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	10/18/2011

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