Provider Demographics
NPI:1942365713
Name:YORRA, MARK N (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:N
Last Name:YORRA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:ATT: CVMC FINANCE DEPT
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-0547
Mailing Address - Country:US
Mailing Address - Phone:802-479-2546
Mailing Address - Fax:802-479-1346
Practice Address - Street 1:14 N MAIN ST
Practice Address - Street 2:SUITE 4002
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-4197
Practice Address - Country:US
Practice Address - Phone:802-479-2546
Practice Address - Fax:802-479-1346
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2014-11-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VT0420006066207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0004784Medicaid
VTVT4784Medicare ID - Type Unspecified
VTVT478401Medicare PIN
VTB85605Medicare UPIN