Provider Demographics
NPI:1790727626
Name:YOSER, SETH L (MD)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:L
Last Name:YOSER
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 1:1264 WESLEY DR
Mailing Address - Street 2:SUITE 302
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116-6400
Mailing Address - Country:US
Mailing Address - Phone:901-348-0415
Mailing Address - Fax:901-348-0419
Practice Address - Street 1:1264 WESLEY DR
Practice Address - Street 2:SUITE 302
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-6400
Practice Address - Country:US
Practice Address - Phone:901-348-0415
Practice Address - Fax:901-348-0419
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000025588207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3084098Medicaid
MS00115871Medicaid
MO208206003Medicaid
3032701OtherBCBS
4410704OtherAETNA
0169183OtherCIGNA
051095479OtherBCBS AL
AR126035001Medicaid
000000113848OtherUNISON
AL000095479Medicaid
0840102OtherUNITED HEALTHCARE
MO208206003Medicaid
AL000095479Medicaid
TN3084098Medicaid
F10028Medicare UPIN
AR126035001Medicaid