Individual
DR. YOHANNES W. YESUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1220 MISSOURI AVE, PATHOLOGY DEPT, JEFFERSONVILLE, IN 47130-3725
(812) 283-2169
(502) 456-4440
Mailing address
1169 EASTERN PKWY, SUITE G71, LOUISVILLE, KY 40217-1417
(502) 456-6212
(502) 456-4440
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01051747
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
36204
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000528992
ANTHEM
IN
05
—
200268960A
—
IN
01
—
3471714000
PASSPORT ADVANTAGE
KY
01
—
50022834
PASSPORT
KY
05
—
64021199
—
KY
01
—
P00430453
MEDICARE RR
IN
Enumeration date
09/28/2006
Last updated
09/12/2011
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