Provider Demographics
NPI:1114953031
Name:YUSKA, MARK E (DPM)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:E
Last Name:YUSKA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 HIGHWAY 59 S
Mailing Address - Street 2:
Mailing Address - City:THIEF RIVER FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56701-4331
Mailing Address - Country:US
Mailing Address - Phone:218-681-4747
Mailing Address - Fax:218-683-2595
Practice Address - Street 1:1720 HIGHWAY 59 S
Practice Address - Street 2:
Practice Address - City:THIEF RIVER FALLS
Practice Address - State:MN
Practice Address - Zip Code:56701
Practice Address - Country:US
Practice Address - Phone:218-681-4747
Practice Address - Fax:218-683-2595
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN592213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN00Q52YUOtherMNBS #
MN13119Medicaid
MN873116OtherAMERICA'S PPO/ARAZ #
MN2700154OtherMEDICA #
MNHP25807OtherHEALTHPARTNERS #
MN141164OtherUCARE #
MNDA9021015708OtherPREFERRED ONE #
MNDA9071015708OtherPREFERRED ONE #
MNMN200028OtherLHS #
MN14872OtherNDBS #
MN2700153OtherMEDICA #
MN58A09YUOtherMNBS #
MN745316700Medicaid
MN15172OtherNDBS #
MNU66290Medicare UPIN
MNDA9071015708OtherPREFERRED ONE #
MN00Q52YUOtherMNBS #
MN15172OtherNDBS #
MN480023364Medicare ID - Type UnspecifiedRR MEDICARE #
MN13119Medicaid