Provider Demographics
NPI:1295812311
Name:YODER, BRENT EMMERICH (MD)
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:EMMERICH
Last Name:YODER
Suffix:
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 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-843-9089
Mailing Address - Fax:717-843-6075
Practice Address - Street 1:924 COLONIAL AVE STE E
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3450
Practice Address - Country:US
Practice Address - Phone:717-843-9089
Practice Address - Fax:717-843-6075
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD434547207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology