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General NPI Number Information
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NPI Number | 1285088930
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Entity Type | Individual
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Provider Name | ISAAC YOURISON
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Gender | Male
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Dates
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Enumeration Date | 04/19/2016
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 301 N 1ST ST
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City | ALTUS
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State | OK
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Zip | 73523-5004
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Country | US
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Telephone | 580-481-5180
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Fax |
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Provider Business Mailing Address
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Address Line | 5700 W GERHART RD
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City | TUCSON
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State | AZ
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Zip | 85745-9320
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Country | US
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Telephone |
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Fax |
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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 | 41093
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License Number State | OK
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