Provider Demographics
NPI:1720032493
Name:YOCUM, JEFFREY ARTHUR (DO)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ARTHUR
Last Name:YOCUM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042
Mailing Address - Country:US
Mailing Address - Phone:717-272-4421
Mailing Address - Fax:717-270-0705
Practice Address - Street 1:940 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042
Practice Address - Country:US
Practice Address - Phone:717-272-4421
Practice Address - Fax:717-270-0705
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS005097L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02611100OtherBLUE CROSS
PA154878OtherBLUE SHIELD
PA001052914000Medicaid
PAB40105Medicare UPIN
PA154878Medicare ID - Type Unspecified