Jonathan Yoder Pllc | |
4414 Lafayette Blvd Ste 236 Fredericksburg VA 22408-4271 | |
(540) 418-7966 | |
(540) 779-8028 |
Full Name | Jonathan Yoder Pllc |
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Speciality | Clinic/Center |
Location | 4414 Lafayette Blvd Ste 236, Fredericksburg, Virginia |
Authorized Official Name and Position | Jonathan Yoder (OWNER) |
Authorized Official Contact | 5404187966 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Jonathan Yoder Pllc 4414 Lafayette Blvd Ste 236 Fredericksburg VA 22408-4271 Ph: (540) 418-7966 | Jonathan Yoder Pllc 4414 Lafayette Blvd Ste 236 Fredericksburg VA 22408-4271 Ph: (540) 418-7966 |
NPI Number | 1023797172 |
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Provider Enumeration Date | 07/17/2023 |
Last Update Date | 11/16/2023 |
Certification Date | 11/16/2023 |
Medicare PECOS PAC ID | 1153760731 |
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Medicare Enrollment ID | O20240416000346 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023797172 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
Provider Name | Jonathan Yoder |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073778973 PECOS PAC ID: 2769635713 Enrollment ID: I20121227000091 |
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