Provider Demographics
NPI:1124096896
Name:YODER, DOUGLAS W (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:W
Last Name:YODER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 HURD AVE
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-2212
Mailing Address - Country:US
Mailing Address - Phone:419-424-9931
Mailing Address - Fax:419-423-0641
Practice Address - Street 1:1725 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1322
Practice Address - Country:US
Practice Address - Phone:419-423-0424
Practice Address - Fax:419-423-0641
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35074179Y208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2139902Medicaid
OHG75587Medicare UPIN
OHH388950Medicare PIN