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General NPI Number Information
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NPI Number | 1467458885
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Entity Type | Individual
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Provider Name | JACKSON J YIUM MD
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Gender | Male
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 960 E 3RD ST STE 208
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City | CHATTANOOGA
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State | TN
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Zip | 37403-2104
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Country | US
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Telephone | 423-778-2550
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Fax |
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Provider Business Mailing Address
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Address Line | 975 E 3RD ST BOX 338
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City | CHATTANOOGA
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State | TN
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Zip | 37403-2147
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Country | US
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Telephone | 423-648-9808
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Fax | 423-648-4570
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 8325
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License Number State | TN
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