Individual provider · Type 1 NPI

Luis Fernando Ycaza Jr., DO

Student in an Organized Health Care Education/Training Program · Johnson City, TN

NPI number 1083554802 Active

Practice location

325 N State Of Franklin Rd
Johnson City, TN 37604-6056

Call (423) 439-7280 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1083554802

Luis Fernando Ycaza Jr., DO's National Provider Identifier is 1083554802, issued on Mar 31, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Johnson City, TN. The record was last updated on Mar 31, 2026.