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Individual

CARLYN YEONG SOOK KO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
630 EATON AVE, HAMILTON, OH 45013-2767
(513) 867-2270
(513) 867-2581
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35083978K
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000326463
BCBS
OH
01
000000372342
ANTHEM/BCBS
OH
05
2484566
OH
01
P00105509
RAIL ROAD MEDICARE
01
P00290024
MEDICARE RAIL ROAD
OH
Enumeration date
05/03/2006
Last updated
05/21/2008
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