Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 2010019812 | MO |
N | 207YS0123X | Facial Plastic Surgeon | 2010019812 | MO |
Y | 207YS0123X | Facial Plastic Surgeon | O-0778 | ID |
NPI | 1639485246 |
---|---|
Provider Name | Morgan Yost |
First Address | Pocatello, ID 83201-5175 |
Second Address | Pocatello, ID 83201-5175 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2010 |
Last Update Date | 01/04/2014 |