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Individual
JOSEPH W YEDLICKA
Active
Individual
JOSEPH W YEDLICKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01041449A
IN
2085R0204X
Vascular & Interventional Radiology Physician
Primary
01041449A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000091491
ANTHEM
IN
05
—
100320970
—
IN
Enumeration date
06/29/2006
Last updated
01/13/2021
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