MEDICARE: DR. FELICIANO B YU 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
1	208000000X	Pediatrics Physician	E-9985	AR
2	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	2010017417	MO
3	208000000X	Pediatrics Physician	2010017417	MO

General Provider Information

NPI Number	:	1689661407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FELICIANO B YU MD

Provider Business Mailing Address
First Line	:	1 CHILDRENS WAY # 653
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72202-3500
Country	:	US
Telephone Number	:	501-364-1100
Fax Number	:	501-364-2963

Provider Business Practice Location Address
First Line	:	1 CHILDRENS WAY # 653
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72202
Country	:	US
Telephone Number	:	501-364-1100
Fax Number	:	501-364-2963

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	05/30/2018

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