Provider Demographics
NPI:1518917368
Name:YACKOVICH, FRANK H (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:H
Last Name:YACKOVICH
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 1:1303 SW FIRST AMERICAN PLACE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-4040
Mailing Address - Country:US
Mailing Address - Phone:785-234-2306
Mailing Address - Fax:785-234-2550
Practice Address - Street 1:1303 SW FIRST AMERICAN PLACE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-4040
Practice Address - Country:US
Practice Address - Phone:785-234-2306
Practice Address - Fax:785-234-2550
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-347512085R0202X
IN01050618A2085R0202X
PAMD048858L2085R0202X
WAMD00035832085R0202X
IL036-1132332085R0202X
AZ342812085R0202X
KY403642085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000393176OtherBCBS
KS1518917368OtherBLUE CROSS & BLUE SHIELD
KY64124092Medicaid
KS200687180BMedicaid
KY0903686Medicare PIN
KY64124092Medicaid
KY000000393176OtherBCBS
KS1518917368OtherBLUE CROSS & BLUE SHIELD
KY00151009Medicare PIN
KS110357009Medicare PIN