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General NPI Number Information
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NPI Number | 1790760411
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Entity Type | Individual
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Provider Name | JOHN J YANNUCCI II MD
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Gender | Male
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Dates
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Enumeration Date | 12/15/2005
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Last Update Date | 08/06/2019
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Provider Practice Location Address
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Address Line | 29 NW 1ST LN
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City | LAMAR
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State | MO
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Zip | 64759
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Country | US
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Telephone | 417-681-5100
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Fax | 417-681-5510
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Provider Business Mailing Address
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Address Line | 29 NW 1ST LN
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City | LAMAR
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State | MO
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Zip | 64759-8105
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Country | US
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Telephone | 417-681-5248
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Fax | 417-681-5748
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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 | ME92786
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2018034961
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License Number State | MO
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