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General NPI Number Information
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NPI Number | 1225030737
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Entity Type | Individual
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Provider Name | MICHAEL WAYNE YOREK M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 09/23/2014
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Provider Practice Location Address
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Address Line | 8595 PICARDY AVE STE 100
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City | BATON ROUGE
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State | LA
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Zip | 70809-3670
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Country | US
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Telephone | 225-763-4900
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Fax | 225-763-4938
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Provider Business Mailing Address
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Address Line | 8490 PICARDY AVE BLDG 200
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City | BATON ROUGE
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State | LA
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Zip | 70809-3731
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Country | US
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Telephone | 225-237-1754
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Fax | 225-237-1722
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | L15377R
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License Number State | LA
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