Provider Demographics
NPI:1487692760
Name:XU, YING (MD)
Entity type:Individual
Prefix:
First Name:YING
Middle Name:
Last Name:XU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4137 KIRBY PKWY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115
Mailing Address - Country:US
Mailing Address - Phone:901-794-3397
Mailing Address - Fax:901-794-3398
Practice Address - Street 1:4137 KIRBY PKWY
Practice Address - Street 2:SUITE 1
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-6532
Practice Address - Country:US
Practice Address - Phone:901-794-3397
Practice Address - Fax:901-794-3398
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD 37830207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3887447Medicaid
H97561Medicare UPIN
TN3887447Medicare ID - Type Unspecified