Provider Demographics
NPI:1184610446
Name:YENCHA, MYRON WILLIAM JR (MD)
Entity type:Individual
Prefix:
First Name:MYRON
Middle Name:WILLIAM
Last Name:YENCHA
Suffix:JR
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 1:55 OFFICE PARK DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-7327
Mailing Address - Country:US
Mailing Address - Phone:910-219-3377
Mailing Address - Fax:910-219-4227
Practice Address - Street 1:55 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7327
Practice Address - Country:US
Practice Address - Phone:910-219-3377
Practice Address - Fax:910-219-4227
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101046907207Y00000X
NC201800981207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology