MEDICARE: KEN YU, ANESTHESIOLOGISTS,P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154654044
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEN YU, ANESTHESIOLOGISTS,P.C.

Provider Business Mailing Address
First Line	:	1964 STATE ST
Second Line	:	SUITE #206
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-4934
Country	:	US
Telephone Number	:	812-949-9918
Fax Number	:	812-941-0289

Provider Business Practice Location Address
First Line	:	1964 STATE ST
Second Line	:	SUITE #206
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-4934
Country	:	US
Telephone Number	:	812-949-9918
Fax Number	:	812-941-0289

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. KEN K YU
Credential	:	M.D.
Telephone Number	:	812-949-9918

Provider Enumeration Date	:	09/10/2009
Last Update Date	:	09/10/2009

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