Healthcare Provider Details

I. General information

NPI: 1184961187
Provider Name (Legal Business Name): JAMES AUSTIN YODER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2013
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N MAIN ST
KENANSVILLE NC
28349-8801
US

IV. Provider business mailing address

NAVAL MEDICAL CENTER 100 BREWSTER BLVD
CAMP LEJEUNE NC
28547-2575
US

V. Phone/Fax

Practice location:
  • Phone: 910-296-0941
  • Fax:
Mailing address:
  • Phone: 910-450-4053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number269054
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: