Provider Demographics
NPI:1619028925
Name:YOST, MATTHEW HAROLD (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:HAROLD
Last Name:YOST
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 1:7144 NW 112TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-2773
Mailing Address - Country:US
Mailing Address - Phone:405-728-3184
Mailing Address - Fax:405-728-3186
Practice Address - Street 1:7144 NW 112TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-2773
Practice Address - Country:US
Practice Address - Phone:405-728-3184
Practice Address - Fax:405-728-3186
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3556111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK$$$$$$$$$Medicare PIN