Organization
Y.C. AHN, M.D., P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YOO CHUL AHN M.D. (PHYSICIAN/CEO)
(580) 243-0100
Entity
Organization
Contact information
Practice address
1800 W 1ST ST, SUITE 1, ELK CITY, OK 73644-3133
(580) 243-0100
(580) 243-0807
Mailing address
1800 W 1ST ST, SUITE 1, ELK CITY, OK 73644-3133
(580) 243-0100
(580) 243-0807
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11651
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
091565914-001
BLUE CROSS BLUE SHIELD
OK
Enumeration date
07/01/2006
Last updated
08/22/2020
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