Provider Demographics
NPI:1245414549
Name:VICTORIA YUNKER, MD
Entity Type:Organization
Organization Name:VICTORIA YUNKER, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:YUNKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-412-4409
Mailing Address - Street 1:10533 TIMBERWOOD CIR
Mailing Address - Street 2:SUITE B
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5365
Mailing Address - Country:US
Mailing Address - Phone:502-412-4409
Mailing Address - Fax:502-412-4410
Practice Address - Street 1:10533 TIMBERWOOD CIR
Practice Address - Street 2:SUITE B
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-5365
Practice Address - Country:US
Practice Address - Phone:502-412-4409
Practice Address - Fax:502-412-4410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-2911041C0700X
KY240772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYC66522Medicare UPIN