DR. JACK SAMIR YAZBECK (NPI# 1780061572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780061572 |
| Entity Type | Individual |
| Full Name | DR. JACK SAMIR YAZBECK |
| Credential | M.D. |
| Practice Address |
Medical Center Blvd Dept of Surgery Winston Salem NC 27157-1021 |
| Practice Telephone | 3367167496 |
| Practice Fax Number | 3367165414 |
| Mailing Telephone | 3367167496 |
| Mailing Fax Number | 3367165414 |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2017-08-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 51510 | SC | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
MEDICAL CENTER BLVD DEPT OF SURGERY |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27157-1021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255960241 | Alexandra Marie Balmaceda | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Center Pathology Dept, #1 Medical Center Blvd., Winston-salem, NC 27157 | 2020-04-02 |
| 1164916680 | Jorie Elizabeth Gatts | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Department of Pediatrics, Winston Salem, NC 27157 | 2018-06-18 |
| 1932606555 | Alexi Rae Ellington Webb | Student in an Organized Health Care Education/Training Program | Wake Forest School of Medicine, Dept of Psychiatry, Medical Center Blvd, Winston Salem, NC 27157 | 2018-04-10 |
| 1851896674 | Wasim Muhammad | Student in an Organized Health Care Education/Training Program | Wake Forest School of Medicine Dept. of Psychiatry, Medical Center Blvd, Winston Salem, NC 27157 | 2018-03-25 |
| 1336643535 | Phillip Martin Kostelic | Student in an Organized Health Care Education/Training Program | Anesthesiology - Wake Forest Baptist Medical Center, 1 Medical Center Blvd, Winston-salem, NC 27157 | 2018-03-21 |
| 1831693324 | Aleah Bond | Student in an Organized Health Care Education/Training Program | Anesthesiology Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-salem, NC 27157 | 2018-03-20 |
| 1134644859 | Ilan Binyamin Klein | Urology | Wake Forest Baptist Health, Department of Urology, Medical Center Boulevard, Winston-salem, NC 27157 | 2017-08-03 |
| 1023467529 | Edward John Doyle IIi | Student in an Organized Health Care Education/Training Program | Wake Forest School of Medicine Dept. of Otolaryngology, Watlington Hall 4th Fl. Medical Center Boulevard, Winston-salem, NC 27157 | 2016-06-07 |
| 1477917888 | Jordan Mae Burner | Student in an Organized Health Care Education/Training Program | Graduate Medical Education Office, Wake Forest Baptist Medical Center, Medical Center Blvd, Winston-salem, NC 27157 | 2016-04-12 |
| 1174900476 | Kate Elise Winterbottom | Speech-Language Pathologist | 4 Janeway Medical Center Blvd, Hearing and Speech, Winston Salem, NC 27157 | 2015-05-06 |
| Find all providers in zip 27157 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790396059 | Healthworks Med Group of North Carolina P C | General Practice | 200 W 2nd St Fl 2, Winston Salem, NC 27101-4019 | 2020-08-11 |
| 1275936064 | Chs North Carolina Medical, P.C. | General Practice | 950 Reynolds Blvd, Winston Salem, NC 27105-3450 | 2014-10-07 |
| 1255684130 | Timothy Clinard Pennell | General Practice | 5401 Covenant Ln, Winston Salem, NC 27106-6459 | 2012-10-17 |
| 1043470958 | William Samuel Otto | General Practice | 2705 Amesbury Rd, Winston Salem, NC 27103-6752 | 2008-06-13 |
| 1861510232 | Lari Calton Young | General Practice | 2512 Reynolda Rd, Winston Salem, NC 27106-4618 | 2007-03-26 |
| 1619370400 | Chs North Carolina Medical, PC | General Practice | 401 N Main St, Winston Salem, NC 27101-3804 | 2014-10-07 |
| 1245678655 | David H Craig | General Practice | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2013-06-07 |
| 1639514938 | Martin Vander Burks Iv | General Practice | Medical Center Boulevard, Winston Salem, NC 27157-0816 | 2013-05-01 |
| 1417264615 | Healthworks Med Group of North Carolina P C | General Practice | 1000 E Hanes Mill Rd, Winston Salem, NC 27105-1384 | 2010-09-09 |
| 1215111828 | Carey Vastine Stabler | General Practice | 190 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2007-12-19 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27157 |
Please comment or provide details below to improve the information on DR. JACK SAMIR YAZBECK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.