Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD063281L | PA |
N | 207QA0401X | Family Doctor - Addiction Medicine | MD063281L | PA |
NPI | 1710947197 |
---|---|
Provider Name | Steven Edward Yordy |
First Address | Middleburg, PA 17842-8910 |
Second Address | Muncy, PA 17756-8807 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2006 |
Last Update Date | 24/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0017057340006 | (05) | PA |