MEDICARE: JOSEPH C YAROCH MD LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center	MD2007-0611	NM

General Provider Information

NPI Number	:	1356537468
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEPH C YAROCH MD LLC

Provider Business Mailing Address
First Line	:	1081 LA QUINTA ST
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88007-4810
Country	:	US
Telephone Number	:	505-524-4054
Fax Number	:	505-524-4054

Provider Business Practice Location Address
First Line	:	1081 LA QUINTA ST
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88007-4810
Country	:	US
Telephone Number	:	505-524-4054
Fax Number	:	505-524-4054

Authorized Official
Title or Position	:	SOLE PROPRIETOR
Name	:	DR. JOSEPH C YAROCH
Credential	:	M.D.
Telephone Number	:	505-524-4054

Provider Enumeration Date	:	09/21/2007
Last Update Date	:	09/21/2007

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