Provider Demographics
NPI:1508865205
Name:YARID, FREDERICK R (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:R
Last Name:YARID
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 1:823 MCFARLAND ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-3438
Mailing Address - Country:US
Mailing Address - Phone:423-587-9777
Mailing Address - Fax:423-587-6689
Practice Address - Street 1:823 MCFARLAND ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3438
Practice Address - Country:US
Practice Address - Phone:423-587-9777
Practice Address - Fax:423-587-6689
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-15
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29767207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3817778Medicare PIN
TNG04673Medicare UPIN