Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NR0200X | Radiology | 038.003452 | IL |
N | 213ER0200X | Radiology | 038.003452 | IL |
Y | 111NR0200X | Radiology | 2228 | CO |
Y | 213ER0200X | Radiology | 2228 | CO |
N | 111NR0200X | Radiology | 4625 | MI |
N | 213ER0200X | Radiology | 4625 | MI |
NPI | 1649375130 |
---|---|
Provider Name | Dr. Terry R. Yochum |
First Address | Arvada, CO 80006-5040 |
Second Address | Arvada, CO 80003-2763 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 30/11/2009 |