Yoohyun Song
Individual provider Active NPI Physician Assistant · Little Rock Afb, AR
NPI 1366198210 · NPPES record last updated Nov 19, 2025
Key facts
- NPI
- 1366198210
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA70064976 (WA)
- Practice address
- 1090 Arnold Dr
Little Rock Afb, AR 72099-4933 - Phone
- (501) 987-3080
- NPI assigned
- Mar 1, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251210003525 | WA | Order and Referring Only - Physician Assistant | 1850885500 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA70064976 | WA | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA70064976 | WA | Yes |
Addresses
Primary practice location
1090 Arnold Dr
Little Rock Afb, AR 72099-4933
Mailing address
1090 Arnold Dr
Little Rock Afb, AR 72099-4933
Phone (501) 987-3080
Other providers in Little Rock Afb, AR
- Jeff J. Sandoval
- Kristie R Sandusky
- Samuel Schmidt
- Timothy Shipp
- Susan Bratcher Smith
- Timothy Ryan Southerland
- Anna R. Stanton
- Sunland Optical Co., Inc.
- Eugene Navarro Tabita
- Paul Teed
All providers in Little Rock Afb, AR · Physician Assistant in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.