Provider Demographics
NPI:1215008065
Name:UY, EDDIE HAO (MD)
Entity type:Individual
Prefix:
First Name:EDDIE
Middle Name:HAO
Last Name:UY
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 1:331 SIJEN AVE
Mailing Address - Street 2:
Mailing Address - City:WHITEMAN AIR FORCE BASE
Mailing Address - State:MO
Mailing Address - Zip Code:65305-1269
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:331 SIJAN AVE
Practice Address - Street 2:
Practice Address - City:KNOB NOSTER
Practice Address - State:MO
Practice Address - Zip Code:65305-3007
Practice Address - Country:US
Practice Address - Phone:660-687-6405
Practice Address - Fax:660-687-1213
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71568208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A715680Medicaid
CAG52461Medicare UPIN
CA00A715680Medicaid