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General NPI Number Information
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NPI Number | 1003808783
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Entity Type | Individual
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Provider Name | JOHN A YEZERSKI MD
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Gender | Male
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 02/25/2016
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Provider Practice Location Address
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Address Line | 300 S 8TH ST SUITE 178W
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City | MURRAY
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State | KY
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Zip | 42071-2444
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Country | US
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Telephone | 270-759-1444
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Fax | 270-752-2856
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Provider Business Mailing Address
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Address Line | 300 S 8TH ST SUITE 480W
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City | MURRAY
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State | KY
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Zip | 42071-2444
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Country | US
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Telephone | 270-759-1444
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Fax | 270-752-2856
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 22751
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License Number State | KY
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