Individual
JERRY RAY YOUKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 PATEWOOD DR, SUITE C300, GREENVILLE, SC 29615-3593
(864) 454-8272
(864) 454-2875
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
20573
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
770001939
RR MEDICARE
SC
05
—
T47223
—
SC
Enumeration date
06/02/2006
Last updated
07/25/2013
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