Basic Information
| Provider Information | |||||||||
| NPI: | 1407833460 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YUE | ||||||||
| FirstName: | ERIC | ||||||||
| MiddleName: | J. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3701 DANFORTH DR | ||||||||
| Address2: | #1208 | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322245215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9042230200 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4500 SAN PABLO RD S | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322241865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9049562000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/29/2005 | ||||||||
| LastUpdateDate: | 12/09/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 0101235248 | VA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 7617274 | 01 | VA | AETNA | OTHER | 010023211 | 05 | VA | MEDICAID | 228922 | 01 | VA | SOUTHERN HEALTH | OTHER | TN0130 | 01 | VA | JOHN DEERE | OTHER | 2123367 | 01 | VA | MAMSI | OTHER | 466409 | 01 | VA | ANTHEM | OTHER | P00058133 | 01 | VA | RAILROAD MEDICARE | OTHER |