Provider Demographics
NPI:1598776825
Name:YOST, MARK FIELDING (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:FIELDING
Last Name:YOST
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 1:201 STATE ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16550-0002
Mailing Address - Country:US
Mailing Address - Phone:814-877-6182
Mailing Address - Fax:814-877-6149
Practice Address - Street 1:201 STATE ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16550-0002
Practice Address - Country:US
Practice Address - Phone:814-877-6182
Practice Address - Fax:814-877-6149
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD053453L2085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00011289701OtherUNIVERA
PA599687OtherBLUE SHIELD
PA1525499OtherGATEWAY
PA147565OtherUNISON - IMAGING CENTER
PA300101155OtherRR MEDICARE
PA304172OtherUPMC
NY01504883OtherNY MEDICAID
PA094897OtherUNISON - HAMOT RADIOLOGY
PA2901747OtherAETNA
OH306985OtherOH MEDICAID
PA147565OtherUNISON - IMAGING CENTER
PA304172OtherUPMC
PA0014869230005Medicaid