Provider Demographics
NPI:1699558650
Name:JOSEPH, YADIN GEORGE (BS)
Entity type:Individual
Prefix:MR
First Name:YADIN
Middle Name:GEORGE
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 HIDDEN LEAF DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-5300
Mailing Address - Country:US
Mailing Address - Phone:405-905-1638
Mailing Address - Fax:
Practice Address - Street 1:3425 HIDDEN LEAF DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-5300
Practice Address - Country:US
Practice Address - Phone:405-905-1638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program