Provider Demographics
NPI:1316352925
Name:YORDON, CAMERON (HAS)
Entity type:Individual
Prefix:MR
First Name:CAMERON
Middle Name:
Last Name:YORDON
Suffix:
Gender:M
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 W 23RD ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-3607
Mailing Address - Country:US
Mailing Address - Phone:850-763-0801
Mailing Address - Fax:850-769-1997
Practice Address - Street 1:1332 N FERDON BLVD
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32536-1749
Practice Address - Country:US
Practice Address - Phone:850-683-8777
Practice Address - Fax:850-683-8785
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4844237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL07937OtherHEARUSA