Healthcare Provider Details

I. General information

NPI: 1558689042
Provider Name (Legal Business Name): LINDSAY EVERT YUNXIU KUO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2010
Last Update Date: 08/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 SPRUCE ST
PHILADELPHIA PA
19104-4206
US

IV. Provider business mailing address

2450 W HUNTING PARK AVE FL 3
PHILADELPHIA PA
19129-1302
US

V. Phone/Fax

Practice location:
  • Phone: 215-662-6156
  • Fax:
Mailing address:
  • Phone: 617-817-7442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD454577
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: