Provider Demographics
NPI:1558897827
Name:FU, YINAN (MD)
Entity Type:Individual
Prefix:DR
First Name:YINAN
Middle Name:
Last Name:FU
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 1:6600 S YALE AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3331
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6465 S YALE AVE STE 420
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7806
Practice Address - Country:US
Practice Address - Phone:918-502-1700
Practice Address - Fax:918-502-1715
Is Sole Proprietor?:No
Enumeration Date:2017-05-05
Last Update Date:2023-07-10
Deactivation Date:2017-12-08
Deactivation Code:
Reactivation Date:2018-02-27
Provider Licenses
StateLicense IDTaxonomies
CAA169970208000000X
OK410952080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics