Provider Demographics
NPI:1568611853
Name:VICTORIA YUNKER MD
Entity Type:Organization
Organization Name:VICTORIA YUNKER MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-807-0633
Mailing Address - Street 1:10533 TIMBERWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5365
Mailing Address - Country:US
Mailing Address - Phone:502-939-6208
Mailing Address - Fax:
Practice Address - Street 1:10533 TIMBERWOOD CIR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-5365
Practice Address - Country:US
Practice Address - Phone:502-939-6208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY24077103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000344257OtherANTHEM
KY1043379886OtherNPI
KY1043379886OtherNPI