Healthcare Provider Details

I. General information

NPI: 1649488164
Provider Name (Legal Business Name): YURI A ZARATE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 06/10/2022
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 S LIMESTONE STE K201
LEXINGTON KY
40536-3500
US

IV. Provider business mailing address

PO BOX 251418
LITTLE ROCK AR
72225-1418
US

V. Phone/Fax

Practice location:
  • Phone: 859-218-2509
  • Fax: 859-323-3499
Mailing address:
  • Phone: 501-364-1100
  • Fax: 501-364-4082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE-7720
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number56526
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License NumberE-7720
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: