Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 42684 | KY |
NPI | 1033247747 |
---|---|
Provider Name | Dr. Jacob Jones Yunker |
First Address | Louisville, KY 40241-6100 |
Second Address | Louisville, KY 40241-6100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 22/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100094230 | (05) | KY |