Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 32182 | KY |
NPI | 1033116132 |
---|---|
Provider Name | James Criss Yelton |
First Address | Madisonville, KY 42431-1661 |
Second Address | Madisonville, KY 42431-1661 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2005 |
Last Update Date | 01/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64321821 | (05) | KY |
A99681 | (02) | KY |