Individual
JEFFERY A YODER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11141 PARKVIEW PLAZA DR STE 305, FORT WAYNE, IN 46845-1715
(260) 484-9611
(260) 484-1004
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01040292A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0998121
—
OH
05
—
100082270
—
IN
05
—
103410352
—
MI
Enumeration date
08/02/2005
Last updated
07/14/2021
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