Individual
JONG MOON WOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3131 QUEEN CITY AVE, OHIO VALLEY ANESTHESIA LLC, CINCINNATI, OH 45238
(859) 341-7246
(859) 341-7867
Mailing address
20 MEDICAL VILLAGE DRIVE, #258, EDGEWOOD, KY 41017
(859) 341-7246
(859) 341-7867
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35046295W
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000257501
ANTHEM BLUE SHIELD
—
05
—
0499045
—
OH
01
—
200413420
INDIANA MEDICAID
—
01
—
64060478
MEDICAID
KY
Enumeration date
11/22/2005
Last updated
06/25/2008
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