Provider Demographics
NPI:1871586867
Name:YUAN, JOSES K H (MD)
Entity type:Individual
Prefix:
First Name:JOSES
Middle Name:K H
Last Name:YUAN
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 1:635 N ERIE ST
Mailing Address - Street 2:RM. 272
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-5317
Mailing Address - Country:US
Mailing Address - Phone:419-213-4049
Mailing Address - Fax:419-213-4017
Practice Address - Street 1:635 N ERIE ST
Practice Address - Street 2:RM. 272
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-5317
Practice Address - Country:US
Practice Address - Phone:419-213-4049
Practice Address - Fax:419-213-4017
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35033986207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2018442OtherAETNA
OH8822331Medicaid
OH00948OtherPHC
OH000000259539OtherANTHEM
OH01-03573OtherUHC
OH0183091Medicaid
OH080159499OtherRRMC
OH00948OtherPHC
OH0183091Medicaid