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Contact Information

STEPHEN YALLOURAKIS, MD
105 W STONE DR
STE 1A
KINGSPORT, TN37660-3256
 Phone: 423-246-8211
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral & Maxillofacial Surgery

204E00000X 02 Physician/General Surgery
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
Indicates primary specialty

NPI Profile & details for STEPHEN YALLOURAKIS · (Male)

NPI Number 1760486682
Status Active
Credentials MD
Entity Individual
Enumeration date 06/09/2005
Last updated 09/24/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • TN License # DS7016
  • TN License # MD24477
  • TN Medicaid 3075591
  • VA Medicaid 7322721
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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