Provider Demographics
NPI:1164404356
Name:YAP, JOHN JONES LIM (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:JONES LIM
Last Name:YAP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4466 W BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3170
Mailing Address - Country:US
Mailing Address - Phone:810-733-1200
Mailing Address - Fax:810-733-0688
Practice Address - Street 1:307 S COURT ST
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-2514
Practice Address - Country:US
Practice Address - Phone:810-667-6110
Practice Address - Fax:810-667-3562
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301059287207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0B51156OtherGROUP BCBSM
CB0923OtherGROUP RAILROAD
1215930490OtherTYPE 2 NPI
MI4230054Medicaid
0N45090OtherGROUP MEDICARE
MI4229222Medicaid
MI4230054Medicaid
0N45090011Medicare ID - Type Unspecified