Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 26632 | TN |
NPI | 1003858796 |
---|---|
Provider Name | Tony Yost |
First Address | Kingsport, TN 37660-4632 |
Second Address | Johnson City, TN 37604-2361 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2006 |
Last Update Date | 06/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3147572 | BLUE CROSS (01) | TN |
3880891 | (05) | TN |
3880897 | (05) | TN |
4152050 | BLUE CROSS (01) | TN |
G05688 | (02) | TN |
P00291228 | RAILROAD MEDICARE (01) | TN |