Provider Demographics
NPI:1659587921
Name:MA, YUCHEN (MD)
Entity Type:Individual
Prefix:
First Name:YUCHEN
Middle Name:
Last Name:MA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2701
Mailing Address - Country:US
Mailing Address - Phone:859-258-6200
Mailing Address - Fax:859-258-6203
Practice Address - Street 1:1401 HARRODSBURG RD STE A120
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3779
Practice Address - Country:US
Practice Address - Phone:859-258-6784
Practice Address - Fax:859-258-6796
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY40500208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100019650Medicaid
KYCB5773OtherRR MEDCIARE GROUP NUMBER
KY7100019650Medicaid
KY37903705OtherMEDICAID LAB
KY4000501OtherMEDICARE LAB
KY7100019650Medicaid