Provider Demographics
NPI:1114376662
Name:YEH, JUSTIN (MD)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:YEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1510
Mailing Address - Country:US
Mailing Address - Phone:812-868-5030
Mailing Address - Fax:812-868-2188
Practice Address - Street 1:4949 HEALTHY WAY STE A
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-1180
Practice Address - Country:US
Practice Address - Phone:812-868-5030
Practice Address - Fax:812-868-2188
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2019-08-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN11018743A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine