Individual
DR. MARY BETH YACKEY
Active
Individual
DR. MARY BETH YACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5517T2429
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000344873
BCBS FACET
—
05
—
200830720
—
IN
05
—
2530701
—
OH
05
—
7100062090
—
KY
01
—
P00409747
RAILROAD MEDICARE
OH
Enumeration date
05/11/2006
Last updated
03/31/2009
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