Provider Demographics
NPI:1982685152
Name:YUSK, JANICE W (MD)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:W
Last Name:YUSK
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 1:4938 BROWNSBORO RD
Mailing Address - Street 2:STE. 206
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-6374
Mailing Address - Country:US
Mailing Address - Phone:502-339-2922
Mailing Address - Fax:502-339-2912
Practice Address - Street 1:4938 BROWNSBORO RD
Practice Address - Street 2:STE. 206
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-6374
Practice Address - Country:US
Practice Address - Phone:502-339-2922
Practice Address - Fax:502-339-2912
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY15981207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYC74389Medicare UPIN
KY6433Medicare PIN