Provider Demographics
NPI:1700497971
Name:YOAKUM, TORI WILLIAM (PHARMD)
Entity Type:Individual
Prefix:
First Name:TORI
Middle Name:WILLIAM
Last Name:YOAKUM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-2045
Mailing Address - Country:US
Mailing Address - Phone:417-626-7878
Mailing Address - Fax:417-781-9319
Practice Address - Street 1:2001 S MAIN ST
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-2045
Practice Address - Country:US
Practice Address - Phone:816-462-2242
Practice Address - Fax:417-781-9319
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017001052183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist