Organization
MARK J. YURCHISIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK J YURCHISIN MD (OWNER)
(270) 843-5111
Entity
Organization
Contact information
Practice address
720 2ND AVE STE 202, BOWLING GREEN, KY 42101-1778
(270) 843-5111
(270) 843-5056
Mailing address
720 2ND AVE STE 202, BOWLING GREEN, KY 42101-1778
(270) 843-5111
(270) 843-5056
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000074762
BLUE CROSS
KY
01
—
P00326568
MEDICARE RAILROAD
KY
Enumeration date
09/13/2007
Last updated
12/12/2012
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