Provider Demographics
NPI:1184840373
Name:U. OF TENNESSEE GME
Entity Type:Organization
Organization Name:U. OF TENNESSEE GME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIOLGY RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FANG
Authorized Official - Middle Name:
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-289-1475
Mailing Address - Street 1:1267 ISLAND HARBOR DRIVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103
Mailing Address - Country:US
Mailing Address - Phone:901-289-1475
Mailing Address - Fax:
Practice Address - Street 1:920 MADISON AVE STE C50
Practice Address - Street 2:UT COLLEGE OF MEDICINE
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-3493
Practice Address - Country:US
Practice Address - Phone:901-448-5364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital