Basic Information
| Provider Information | |||||||||
| NPI: | 1295812311 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YODER | ||||||||
| FirstName: | BRENT | ||||||||
| MiddleName: | EMMERICH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 924 COLONIAL AVE STE E | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174033450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178439089 | ||||||||
| FaxNumber: | 7178436075 | ||||||||
| Practice Location | |||||||||
| Address1: | 924 COLONIAL AVE STE E | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174033450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178439089 | ||||||||
| FaxNumber: | 7178436075 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 02/09/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | MD434547 | PA | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.