Individual
LUIS FERNANDO YCAZA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
325 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6056
(423) 439-7280
Mailing address
325 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6056
(423) 439-7280
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/31/2026
Last updated
03/31/2026
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