Most Relevant Information
Provider Data
| NPI Number: | 1003507112 |
| Provider Name: | SELENA YAKABE DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/18/2023 |
| Last Updated: | 05/18/2023 |
Provider Practice Location
300 EAST HOSPITAL ROAD
FORT GORDON
GA
30905
Practice Location Phone/Fax
| Phone: | 7067875811 |
| Fax: |
Provider Mailing Location
300 EAST HOSPITAL ROAD
FORT GORDON
GA
309055650
Provider Mailing Phone/Fax
| Phone: | 7067875811 |
| Fax: |