Provider Demographics
NPI:1790845832
Name:TSAI, YI YI (MD)
Entity Type:Individual
Prefix:
First Name:YI YI
Middle Name:
Last Name:TSAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 DUTCHMANS PKWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205
Mailing Address - Country:US
Mailing Address - Phone:502-897-1740
Mailing Address - Fax:502-896-1294
Practice Address - Street 1:6400 DUTCHMANS PKWY
Practice Address - Street 2:SUITE 210
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205
Practice Address - Country:US
Practice Address - Phone:502-897-1740
Practice Address - Fax:502-896-1294
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY28194207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64281942Medicaid
KY64281942Medicaid
KY1692401Medicare ID - Type Unspecified