Individual
BRUCE YACYSHYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 PIEDMONT AVE, CINCINNATI, OH 45219-4231
(513) 475-7505
(513) 475-7355
Mailing address
PO BOX 636256, CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5507
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35.080517
OH
207RG0100X
Gastroenterology Physician
01064973A
IN
207RG0100X
Gastroenterology Physician
Primary
35.080517
OH
207RG0100X
Gastroenterology Physician
R9F93
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200846990
—
IN
05
—
2332783
—
OH
05
—
7100037650
—
KY
Enumeration date
07/29/2006
Last updated
11/03/2025
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