Provider Demographics
NPI:1952929689
Name:YASIR LLC
Entity Type:Organization
Organization Name:YASIR LLC
Other - Org Name:OURPHONEMD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YASIR
Authorized Official - Middle Name:
Authorized Official - Last Name:SAIFULLAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-600-0136
Mailing Address - Street 1:103 FINANCIAL PL STE 300
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-4470
Mailing Address - Country:US
Mailing Address - Phone:270-600-0136
Mailing Address - Fax:
Practice Address - Street 1:103 FINANCIAL PL STE 300
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-4470
Practice Address - Country:US
Practice Address - Phone:270-600-0136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-09
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100676730OtherKY MEDICAID