| Dr Ryan Young Jin, MD, PHD | |
|
717 Kimole Lane, # 130, Adrian, MI 49221 | |
| (517) 265-0292 | |
| (517) 265-9220 |
| Full Name | Dr Ryan Young Jin |
|---|---|
| Gender | Male |
| Speciality | Radiation Oncology |
| Experience | 22 Years |
| Location | 717 Kimole Lane, Adrian, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568671113 | NPI | - | NPPES |
| 2849681 | Medicaid | OH | |
| P00727166 | Other | OH | RR MEDICARE |
| P00972313 | Other | MI | RR MEDICARE |
| 158671113 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0001X | Radiology - Radiation Oncology | 35-091603 (Ohio) | Secondary |
| 2085R0001X | Radiology - Radiation Oncology | 4301081853 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Emma L Bixby Medical Center | Adrian, MI | Hospital |
| Promedica Toledo Hospital | Toledo, OH | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Promedica Multi Specialty Physicians | 7113182809 | 141 |
| Promedica Multi Specialty Physicians | 7113182809 | 141 |
| Entity Name | Promedica Central Physicians |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043270150 PECOS PAC ID: 2365348190 Enrollment ID: O20031211000226 |
| Entity Name | Promedica Multi Specialty Physicians |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306105150 PECOS PAC ID: 7113182809 Enrollment ID: O20120702000334 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ryan Young Jin, MD, PHD 1 Seagate # 800, Toledo, OH 43604-1558 Ph: (517) 265-0292 | Dr Ryan Young Jin, MD, PHD 717 Kimole Lane, # 130, Adrian, MI 49221 Ph: (517) 265-0292 |
Richard Leroy Taylor, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 2550 N Adrian Hwy, Adrian, MI 49221 Phone: 800-764-7297 | |
Dr. Marinus Vanooyen, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 3416 Birnwick Dr, Adrian, MI 49221 Phone: 517-263-8975 Fax: 517-264-5997 |