Individual
EDWARD HENRY YOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
8803 S 101ST EAST AVE, SUITE 335, TULSA, OK 74133-7550
(918) 307-0215
(918) 250-7669
Mailing address
8803 S 101ST EAST AVE, SUITE 335, TULSA, OK 74133-7550
(918) 307-0215
(918) 250-7669
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
2842
OK
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
2842
OK
207NS0135X
Procedural Dermatology Physician
2842
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070015931
RAILROAD MEDICARE
OK
05
—
100025020A
—
OK
Enumeration date
10/18/2005
Last updated
06/16/2011
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