Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 2242 | SC |
NPI | 1023086543 |
---|---|
Provider Name | Dr. Jason Allen Yoder |
First Address | Lexington, SC 29072-2137 |
Second Address | Lexington, SC 29072-2137 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2006 |
Last Update Date | 23/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CH2242 GROUP GCH 28 | (05) | SC |