Healthcare Provider Details

I. General information

NPI: 1972747087
Provider Name (Legal Business Name): JASON ANDREW YAUN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2009
Last Update Date: 03/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 N DUNLAP ST STE 350
MEMPHIS TN
38105-4625
US

IV. Provider business mailing address

51 N DUNLAP ST STE 350
MEMPHIS TN
38105-4625
US

V. Phone/Fax

Practice location:
  • Phone: 901-448-5364
  • Fax:
Mailing address:
  • Phone: 901-287-7337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number48931
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: