Healthcare Provider Details

I. General information

NPI: 1578500807
Provider Name (Legal Business Name): JOHN A YARWOOD PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 06/24/2021
Certification Date: 06/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 WALNUT BOTTOM RD
SHIPPENSBURG PA
17257-8219
US

IV. Provider business mailing address

785 5TH AVE SUITE 3
CHAMBERSBURG PA
17201-4232
US

V. Phone/Fax

Practice location:
  • Phone: 717-532-4148
  • Fax: 717-532-3561
Mailing address:
  • Phone: 717-263-9555
  • Fax: 717-262-4218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA002915L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: