Individual
DR. JACQUELINE MARGARET YOUTSOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2425 BRADSHAW WAY, PITTSBURG, KS 66762-6600
(620) 308-6123
(620) 308-6264
Mailing address
2425 BRADSHAW WAY, PITTSBURG, KS 66762-6600
(620) 308-6123
(620) 308-6264
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
0438483
KS
207Q00000X
Family Medicine Physician
Primary
0438483
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201124850A
—
KS
Enumeration date
03/28/2012
Last updated
10/13/2020
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