Provider Demographics
NPI:1013390467
Name:YANCEY, JUSTIN LEONADUS (DO)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:LEONADUS
Last Name:YANCEY
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:7640 WOLF RIVER CIR FL 2
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1744
Mailing Address - Country:US
Mailing Address - Phone:901-755-0208
Mailing Address - Fax:901-757-0208
Practice Address - Street 1:7640 WOLF RIVER CIR FL 2
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1744
Practice Address - Country:US
Practice Address - Phone:901-755-0208
Practice Address - Fax:901-757-0208
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS26588207R00000X
TN3793207R00000X, 207RN0300X
MST-3032207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine