Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 3228 | OH |
NPI | 1720173495 |
---|---|
Provider Name | Dr. John Dean Yerkey |
First Address | Boardman, OH 44512 |
Second Address | Boardman, OH 44512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 08/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000210288 | ANTHEM (01) | OH |
2263456 | (05) | OH |
341964808 | TAX ID (01) | OH |
409748 | CARELINK (01) | OH |
607277100 | DEPT OF LABOR (01) | OH |
7974310 | AETNA (01) | OH |
DD3566 | RAIL ROAD MEDICARE (01) | OH |
U86466 | (02) | OH |