Provider Demographics
NPI:1790764322
Name:YOAKUM, DAVID ROLAND JR (PHARMD, CDE)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROLAND
Last Name:YOAKUM
Suffix:JR
Gender:M
Credentials:PHARMD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:RAINELLE
Mailing Address - State:WV
Mailing Address - Zip Code:25962-1064
Mailing Address - Country:US
Mailing Address - Phone:304-438-6186
Mailing Address - Fax:304-438-6185
Practice Address - Street 1:176 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:RAINELLE
Practice Address - State:WV
Practice Address - Zip Code:25962-1064
Practice Address - Country:US
Practice Address - Phone:304-438-6186
Practice Address - Fax:304-438-6185
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV5967183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist