Jip J Yoon, M.D.
Individual provider Active NPI Internal Medicine Physician · Loogootee, IN
NPI 1972506418 · NPPES record last updated Dec 22, 2009
Key facts
- NPI
- 1972506418
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 01038083 (IN)
- Practice address
- 404 N John F Kennedy Ave
Loogootee, IN 47553-1219 - Phone
- (812) 295-2380
- Fax
- (812) 295-2215
- NPI assigned
- May 28, 2005
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01038083 | IN | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01038083 | IN | Yes |
Addresses
Primary practice location
404 N John F Kennedy Ave
Loogootee, IN 47553-1219
Mailing address
404 N John F Kennedy Ave
Loogootee, IN 47553-1219
Phone (812) 295-2380
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 311066904 | Other | IN | FEDERAL TAX ID NO |
| 100159120 | Medicaid | IN |
Other providers in Loogootee, IN
- Paige M Werner
- Williams Bros Health Care Pharmacy Inc
- Williams Bros. Health Care Pharmacy, Inc.
- Makayla Dawn Wittmer
- Austin Tyler Yoder
All providers in Loogootee, IN · Internal Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 22, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.