Individual
JEFFREY R YESSENOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9250 COLUMBIA AVE, STE A2, MUNSTER, IN 46321
(219) 513-1300
(219) 513-2385
Mailing address
9250 COLUMBIA AVE, STE A2, MUNSTER, IN 46321
(219) 513-1300
(219) 513-2385
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
01030811A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100214810
—
IN
Enumeration date
07/29/2005
Last updated
04/29/2008
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