Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 01038811A | IN |
N | 207QA0401X | Family Doctor - Addiction Medicine | 01038811A | IN |
NPI | 1730298746 |
---|---|
Provider Name | Yolanda Joy Yoder |
First Address | Paoli, IN 47454-8821 |
Second Address | Paoli, IN 47454-8821 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 10/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100360410A | (05) | IN |
E66817 | (02) | IN |