Provider Demographics
NPI:1700279346
Name:NATIONAL PHYSICIANS GROUP, LLC
Entity Type:Organization
Organization Name:NATIONAL PHYSICIANS GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:YARKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-947-3340
Mailing Address - Street 1:1500 W CYPRESS CREEK RD
Mailing Address - Street 2:SUITE 417
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1874
Mailing Address - Country:US
Mailing Address - Phone:954-947-3340
Mailing Address - Fax:
Practice Address - Street 1:1500 W CYPRESS CREEK RD
Practice Address - Street 2:SUITE 417
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1874
Practice Address - Country:US
Practice Address - Phone:954-947-3340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Single Specialty