Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 22751 | KY |
NPI | 1003808783 |
---|---|
Provider Name | John A Yezerski |
First Address | Murray, KY 42071-2444 |
Second Address | Murray, KY 42071-2444 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2005 |
Last Update Date | 25/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64227515 | (05) | KY |