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General NPI Number Information
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NPI Number | 1982902342
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Entity Type | Organization
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Legal Business Name | DR. DAVID B. YABLONSKY, D.O., P.C.
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Dates
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Enumeration Date | 03/09/2011
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Last Update Date | 12/08/2015
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Provider Practice Location Address
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Address Line | 2023 VADALABENE DR SUITE 251
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City | MARYVILLE
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State | IL
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Zip | 62062-5630
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Country | US
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Telephone | 618-288-8850
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Fax | 618-288-8943
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Provider Business Mailing Address
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Address Line | 2023 VADALABENE DR SUITE 251
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City | MARYVILLE
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State | IL
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Zip | 62062-5630
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Country | US
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Telephone | 618-288-8850
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Fax | 618-288-8943
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Authorized Official
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Title or Position | OWNER / PHYSICIAN
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Name | DR. DAVID B. YABLONSKY
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Credential | D.O.
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Telephone | 618-628-8211
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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 | 036115282
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036115282
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License Number State | IL
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