Organization
KENNETH E YAGODICH, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH ERIC YAGODICH MD (PRESIDENT)
(812) 868-0800
Entity
Organization
Contact information
Practice address
1200 HEINLEIN RD, EVANSVILLE, IN 47725-6379
(812) 868-0800
(812) 868-0804
Mailing address
1200 HEINLEIN RD, EVANSVILLE, IN 47725-6379
(812) 868-0800
(812) 868-0804
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01037698
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578604633
TYPE I NPI
IN
Enumeration date
03/21/2012
Last updated
03/21/2012
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