Basic Information
| Provider Information | |||||||||
| NPI: | 1033247747 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YUNKER | ||||||||
| FirstName: | JACOB | ||||||||
| MiddleName: | JONES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3810 SPRINGHURST BLVD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402416100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028979881 | ||||||||
| FaxNumber: | 5028979824 | ||||||||
| Practice Location | |||||||||
| Address1: | 3810 SPRINGHURST BLVD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402416100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028979881 | ||||||||
| FaxNumber: | 5028979824 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2007 | ||||||||
| LastUpdateDate: | 10/22/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 42684 | KY | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 7100094230 | 05 | KY | MEDICAID |