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NPI Code Detail

MEDICARE: JERRY YUE SHEN MD

MEDICARE: JERRY YUE SHEN MD
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
1207Q00000XFamily Medicine Physician51599AZ

Other Identifiers

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

General Provider Information

NPI Number : 1306283882
Entity Type Code : Individual
Provider Name (Legal Business Name) : JERRY YUE SHEN MD
Provider Business Mailing Address
First Line : PO BOX 31235
Second Line :
City : TUCSON
State : AZ
Zip : 85751-1235
Country : US
Telephone Number : 520-324-4100
Fax Number : 520-324-1406
Provider Business Practice Location Address
First Line : 70 N HARRISON RD
Second Line :
City : TUCSON
State : AZ
Zip : 85748-3260
Country : US
Telephone Number : 520-324-4403
Fax Number : 520-324-1409
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2013
Last Update Date : 05/13/2021

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