Healthcare Provider Details

I. General information

NPI: 1083091367
Provider Name (Legal Business Name): GEORGE YAKUBEK D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2015
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1086 FRANKLIN ST
JOHNSTOWN PA
15905-4305
US

IV. Provider business mailing address

1086 FRANKLIN ST
JOHNSTOWN PA
15905-4305
US

V. Phone/Fax

Practice location:
  • Phone: 814-534-9000
  • Fax:
Mailing address:
  • Phone: 814-534-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number34.012705
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberOT025746
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: