# PAUL T YODER MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578746921
- **Authorized official:** PAUL YODER MD (OWNER)
- **Authorized official phone:** (928) 363-1173

## Contact information

- **Practice address:** 904 N OVERLOOK CIR, PAYSON, AZ 85541-6601
- **Practice address phone:** (928) 363-1173
- **Mailing address:** 904 N OVERLOOK CIR, PAYSON, AZ 85541-6601
- **Mailing address phone:** (928) 363-1173
- **Mailing address fax:** (928) 363-1173

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 31473 | AZ | Yes |

## Other

- **Enumeration date:** 12/07/2007
- **Last updated:** 02/27/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | AZ0735560 | BLUE CROSS | AZ |