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General NPI Number Information
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NPI Number | 1497865240
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Entity Type | Organization
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Legal Business Name | VINCENT T YU MD PC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 02/05/2015
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Provider Practice Location Address
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Address Line | 1121 MAIN ST
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City | CANON CITY
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State | CO
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Zip | 81212-3413
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Country | US
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Telephone | 719-276-2116
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Fax | 719-276-6919
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Provider Business Mailing Address
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Address Line | P.O. BOX 1614
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City | CANON CITY
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State | CO
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Zip | 81212-1614
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Country | US
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Telephone | 719-276-2116
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Fax | 719-276-6919
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Authorized Official
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Title or Position | OWNER
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Name | MR. VINCENT T. YU
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Credential | M.D.
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Telephone | 719-276-2116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 30832
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License Number State | CO
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