Individual
JERRY YUAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11459 JOHNS CREEK PKWY, SUITE 170, JOHNS CREEK, GA 30097-3515
(678) 417-0400
(678) 417-0483
Mailing address
1930 BRANNAN RD, MCDONOUGH, GA 30253-4310
(678) 284-4040
(678) 284-4076
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
042495
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000722543F
—
GA
01
—
2361088
AETNA
—
01
—
30533
TRICARE
—
01
—
P00617411
RAILROAD MEDICARE
GA
Enumeration date
03/16/2006
Last updated
03/07/2023
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