Healthcare Provider Details

I. General information

NPI: 1225001019
Provider Name (Legal Business Name): MICHAEL DEAN YOST D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 05/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 W 12TH AVE STE 105
EMPORIA KS
66801-2588
US

IV. Provider business mailing address

1201 W 12TH AVE
EMPORIA KS
66801-2504
US

V. Phone/Fax

Practice location:
  • Phone: 620-340-6181
  • Fax: 620-340-6182
Mailing address:
  • Phone: 620-343-6800
  • Fax: 620-341-7821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberOS 9644
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: