Provider Demographics
NPI:1770999310
Name:YODER, MARGARET (DO)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:YODER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3443 N AMIDON AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67204-4147
Mailing Address - Country:US
Mailing Address - Phone:316-838-8585
Mailing Address - Fax:316-838-6222
Practice Address - Street 1:3443 N AMIDON AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67204-4147
Practice Address - Country:US
Practice Address - Phone:316-838-8585
Practice Address - Fax:316-838-6222
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-03
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT015918207Q00000X
KS05-40915207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty