Basic Information
| Provider Information | |||||||||
| NPI: | 1922247022 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | JOO | ||||||||
| FirstName: | HYON | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | WRIGHT STATE UNIVERSITY C/O PSYCHIATRY DEPT | ||||||||
| Address2: | P. O. BOX 927 | ||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372238840 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4881 SUGAR MAPLE DR | ||||||||
| Address2: | 88MDG/SGOH | ||||||||
| City: | WRIGHT PATTERSON AFB | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454335546 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7752500327 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2009 | ||||||||
| LastUpdateDate: | 02/12/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 58.002936 | OH | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.