Provider Demographics
NPI:1942426861
Name:FREDERICK R. YARID
Entity Type:Organization
Organization Name:FREDERICK R. YARID
Other - Org Name:HAMBLEN FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:YARID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-587-9777
Mailing Address - Street 1:823 MCFARLAND ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-3438
Mailing Address - Country:US
Mailing Address - Phone:423-587-9777
Mailing Address - Fax:423-587-6689
Practice Address - Street 1:823 MCFARLAND ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3438
Practice Address - Country:US
Practice Address - Phone:423-587-9777
Practice Address - Fax:423-587-6689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3712298Medicare ID - Type Unspecified