Provider Demographics
NPI:1770646861
Name:YING XU
Entity Type:Organization
Organization Name:YING XU
Other - Org Name:THE HUTCHINSON CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YING
Authorized Official - Middle Name:
Authorized Official - Last Name:XU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-794-3397
Mailing Address - Street 1:4137 KIRBY PARKWAY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115
Mailing Address - Country:US
Mailing Address - Phone:901-794-3397
Mailing Address - Fax:901-794-3398
Practice Address - Street 1:4137 KIRBY PARKWAY
Practice Address - Street 2:SUITE 1
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115
Practice Address - Country:US
Practice Address - Phone:901-794-3397
Practice Address - Fax:901-794-3398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3732658Medicaid
MS07550343OtherMEDICAID OF MS
TN3732658Medicaid