Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 8722 | AL |
NPI | 1205817947 |
---|---|
Provider Name | Dr. Yu-Yong Tai |
First Address | Jasper, AL 35501 |
Second Address | Jasper, AL 35501-6154 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2005 |
Last Update Date | 07/01/2011 |