Provider Demographics
NPI:1346266897
Name:YANTZ, CINDI A (MD)
Entity Type:Individual
Prefix:
First Name:CINDI
Middle Name:A
Last Name:YANTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 BUTNER DR
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:IN
Mailing Address - Zip Code:47246-9447
Mailing Address - Country:US
Mailing Address - Phone:812-546-6000
Mailing Address - Fax:812-546-0368
Practice Address - Street 1:163 BUTNER DR
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:IN
Practice Address - Zip Code:47246-9447
Practice Address - Country:US
Practice Address - Phone:812-546-6000
Practice Address - Fax:812-546-0368
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01064386A207Q00000X
FLME71593207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200880630Medicaid
32277AMedicare ID - Type Unspecified
IN200880630Medicaid