Provider Demographics
NPI:1467479287
Name:YABLONG, JEFFREY (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:YABLONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 SOUTHLAND DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503
Mailing Address - Country:US
Mailing Address - Phone:859-313-5130
Mailing Address - Fax:859-313-5144
Practice Address - Street 1:336 GOLFVIEW RD
Practice Address - Street 2:UNIT 1105
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-3513
Practice Address - Country:US
Practice Address - Phone:260-450-3927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33762207P00000X
IN01046618207P00000X
FLME95304208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000088957OtherANTHEM
IN930082437OtherRAILROAD
IN200139750Medicaid
OH2729542Medicaid
IN930082437OtherRAILROAD
IN138420A1Medicare PIN
IN200139750Medicaid
IN295910UUMedicare PIN
IN142520HMedicare PIN