Healthcare Provider Details

I. General information

NPI: 1548361256
Provider Name (Legal Business Name): FRANK WALLACE YODER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 02/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7450 HOSPITAL DR SUITE 370
DUBLIN OH
43016-9642
US

IV. Provider business mailing address

5300 FAR HILLS AVENUE
DAYTON OH
45429-2347
US

V. Phone/Fax

Practice location:
  • Phone: 614-760-1401
  • Fax: 614-652-3048
Mailing address:
  • Phone: 937-433-7536
  • Fax: 937-433-9612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number35036531Y
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: