Healthcare Provider Details

I. General information

NPI: 1962484113
Provider Name (Legal Business Name): GREGORY JEN-LEN YEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: GREGORY JEN-LEN YI MD

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 08/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 DUFF AVE
AMES IA
50010-3014
US

IV. Provider business mailing address

1111 DUFF AVE
AMES IA
50010-3014
US

V. Phone/Fax

Practice location:
  • Phone: 515-239-2411
  • Fax: 515-239-2492
Mailing address:
  • Phone: 515-239-2411
  • Fax: 515-239-2492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number27278
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: