MEDICARE: GARY E YOCHIM DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	02348	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1055548	OTHER	KY	PASSPORT
2	000000245561	OTHER	KY	ANTHEM
3	2433779000	OTHER	KY	PASSPORT ADVANTAGE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275537029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY E YOCHIM DO

Provider Business Mailing Address
First Line	:	910 WALLACE AVE
Second Line	:	STE 301
City	:	LEITCHFIELD
State	:	KY
Zip	:	42754-1418
Country	:	US
Telephone Number	:	270-259-9651
Fax Number	:

Provider Business Practice Location Address
First Line	:	910 WALLACE AVE
Second Line	:	STE 301
City	:	LEITCHFIELD
State	:	KY
Zip	:	42754-1418
Country	:	US
Telephone Number	:	270-259-9651
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	04/21/2008

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Directions to “ GARY E YOCHIM DO” Practice Location

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