MEDICARE: DR. YVONNE HEARN MD

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	H2448	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8S9311	OTHER	TX	BLUE CROSS

General Provider Information

NPI Number	:	1477505451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YVONNE HEARN MD

Provider Business Mailing Address
First Line	:	1209 BROOK AVE
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76301-5601
Country	:	US
Telephone Number	:	940-322-8935
Fax Number	:	940-322-8938

Provider Business Practice Location Address
First Line	:	1107 BROOK AVE
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76301-5008
Country	:	US
Telephone Number	:	940-322-8800
Fax Number	:	940-322-8833

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	04/04/2008

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Directions to “ DR. YVONNE HEARN MD” Practice Location

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