Provider Demographics
NPI:1366442121
Name:YUN, WON KHILL (MD)
Entity type:Individual
Prefix:DR
First Name:WON
Middle Name:KHILL
Last Name:YUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 CORNWALL RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-7089
Mailing Address - Country:US
Mailing Address - Phone:717-273-8147
Mailing Address - Fax:717-273-8907
Practice Address - Street 1:618 CORNWALL RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7089
Practice Address - Country:US
Practice Address - Phone:717-273-8147
Practice Address - Fax:717-273-8907
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD034485L174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB40357Medicare UPIN