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General NPI Number Information
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NPI Number | 1881951291
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Entity Type | Organization
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Legal Business Name | JOSEPH W. YERGER
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 04/24/2012
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Provider Practice Location Address
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Address Line | 1403 JOHNSON ST
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City | TALLULAH
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State | LA
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Zip | 71282-5513
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Country | US
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Telephone | 318-574-0765
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Fax | 318-574-3464
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Provider Business Mailing Address
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Address Line | PO BOX 709
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City | TALLULAH
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State | LA
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Zip | 71284-0709
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Country | US
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Telephone | 318-574-0765
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Fax | 318-574-3464
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH W. YERGER
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Credential |
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Telephone | 318-574-0765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2017
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License Number State | LA
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