Provider Demographics
NPI:1265889844
Name:YOST, MARK ALLEN (DO)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALLEN
Last Name:YOST
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 12TH STREET EXT
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-2352
Mailing Address - Country:US
Mailing Address - Phone:304-431-5168
Mailing Address - Fax:
Practice Address - Street 1:401 VERMILLION STREET
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:WV
Practice Address - Zip Code:24712-0697
Practice Address - Country:US
Practice Address - Phone:304-384-7325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-24
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3329207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine