Provider Demographics
NPI:1801981907
Name:YODER, WILLIAM
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:YODER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 ORISKANY BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITESBORO
Mailing Address - State:NY
Mailing Address - Zip Code:13492-1408
Mailing Address - Country:US
Mailing Address - Phone:315-736-3324
Mailing Address - Fax:315-736-3325
Practice Address - Street 1:312 ORISKANY BLVD
Practice Address - Street 2:
Practice Address - City:WHITESBORO
Practice Address - State:NY
Practice Address - Zip Code:13492-1408
Practice Address - Country:US
Practice Address - Phone:315-736-3324
Practice Address - Fax:315-736-3325
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX-004778-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT26721Medicare UPIN
NY50592-BMedicare PIN