Provider Demographics
NPI:1225751217
Name:YANCHICK, JEFFREY STEPHEN (MPH, DPH)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:STEPHEN
Last Name:YANCHICK
Suffix:
Gender:M
Credentials:MPH, DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 N LAWSON BLVD
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:OK
Mailing Address - Zip Code:74536
Mailing Address - Country:US
Mailing Address - Phone:918-569-4884
Mailing Address - Fax:918-569-4660
Practice Address - Street 1:536 N LAWSON BLVD
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:OK
Practice Address - Zip Code:74536-7453
Practice Address - Country:US
Practice Address - Phone:918-569-4884
Practice Address - Fax:918-569-4660
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11290183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist