Healthcare Provider Details

I. General information

NPI: 1023451580
Provider Name (Legal Business Name): CODY SCOTT YERGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2013
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 GEMINI PL STE 300
COLUMBUS OH
43240-6112
US

IV. Provider business mailing address

PO BOX 734439
CHICAGO IL
60673-4439
US

V. Phone/Fax

Practice location:
  • Phone: 614-383-6450
  • Fax: 614-383-6455
Mailing address:
  • Phone: 317-706-3415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01074662A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number35.151192
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: