Provider Demographics
NPI:1730127945
Name:JEAN-CLAUDE, YVELINE D (MD)
Entity Type:Individual
Prefix:
First Name:YVELINE
Middle Name:D
Last Name:JEAN-CLAUDE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 SMITH AVE
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-5533
Mailing Address - Country:US
Mailing Address - Phone:229-227-1595
Mailing Address - Fax:229-227-1385
Practice Address - Street 1:334 SMITH AVE
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-5533
Practice Address - Country:US
Practice Address - Phone:229-227-1595
Practice Address - Fax:229-227-1385
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014010413207RN0300X
GA051950207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000962871GMedicaid
GA000962871EMedicaid
GA000962871AMedicaid
GA000962871BMedicaid
GA000962871CMedicaid
GA000962871DMedicaid
GA000962871GMedicaid
GA000962871BMedicaid
GA000962871AMedicaid
GAF20992Medicare UPIN