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General NPI Number Information
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NPI Number | 1770819567
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Entity Type | Individual
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Provider Name | WILLIAM ALLEN YODER DPM
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Gender | Male
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Dates
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Enumeration Date | 10/28/2009
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Last Update Date | 07/14/2011
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Provider Practice Location Address
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Address Line | 3535 30TH AVE SUITE 203
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City | KENOSHA
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State | WI
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Zip | 53144-1632
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Country | US
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Telephone | 262-657-6104
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Fax | 262-657-6194
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Provider Business Mailing Address
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Address Line | 3535 30TH AVE SUITE 203
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City | KENOSHA
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State | WI
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Zip | 53144-1632
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Country | US
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Telephone | 262-657-6104
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Fax | 262-657-6194
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 36.003528
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 988-025
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License Number State | WI
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