MEDICARE: YU JIM LI 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	207ZC0500X	Cytopathology Physician	47029	WI
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	2017037834	MO

General Provider Information

NPI Number	:	1861454035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YU JIM LI MD

Provider Business Mailing Address
First Line	:	PO BOX 744327
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-4327
Country	:	US
Telephone Number	:	816-698-7011
Fax Number	:	816-698-7016

Provider Business Practice Location Address
First Line	:	19600 E 39TH ST S
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64057-2301
Country	:	US
Telephone Number	:	816-698-7011
Fax Number	:	816-698-7016

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

Provider Enumeration Date	:	04/04/2006
Last Update Date	:	09/18/2024

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Directions to “ YU JIM LI MD” Practice Location

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