Individual
DR. JON ANTHONY YOKUBAITIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1767 IMPERIAL BLVD, LAKE CHARLES, LA 70605-5362
(337) 478-3810
(337) 478-6360
Mailing address
1767 IMPERIAL BLVD, LAKE CHARLES, LA 70605-5362
(337) 478-3810
(337) 478-6360
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
09387R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180046392
RAILROAD MEDICARE
LA
05
—
1934542
—
LA
01
—
5508154
AETNA
LA
01
—
720680677015
CIGNA
LA
Enumeration date
11/16/2005
Last updated
05/19/2020
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