Provider Demographics
NPI:1598326688
Name:YUAN, PHILIP LIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:LIN
Last Name:YUAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2735 RALEIGH DR APT C
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-6786
Mailing Address - Country:US
Mailing Address - Phone:317-532-7618
Mailing Address - Fax:
Practice Address - Street 1:710 N SAINT JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-5557
Practice Address - Country:US
Practice Address - Phone:812-426-1180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26028019A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist