MEDICARE: DR. ELLIOTT A YOLLES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	01025241	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	182568540	OTHER	IN	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326038654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELLIOTT A YOLLES MD

Provider Business Mailing Address
First Line	:	2020 W 86TH ST
Second Line	:	SUITE 104
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-1969
Country	:	US
Telephone Number	:	317-872-8772
Fax Number	:	317-872-2383

Provider Business Practice Location Address
First Line	:	2020 W 86TH ST
Second Line	:	SUITE 104
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-1969
Country	:	US
Telephone Number	:	317-872-8772
Fax Number	:	317-872-2383

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	01/04/2008

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