Provider Demographics
NPI:1538490271
Name:YUKON, RONALD JOEL (DC)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:JOEL
Last Name:YUKON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2731 RUDY ROAD
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956
Mailing Address - Country:US
Mailing Address - Phone:479-474-2225
Mailing Address - Fax:479-474-4908
Practice Address - Street 1:2731 RUDY ROAD
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956
Practice Address - Country:US
Practice Address - Phone:479-474-2225
Practice Address - Fax:479-474-4908
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1204111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR55736Medicare UPIN