Healthcare Provider Details

I. General information

NPI: 1083883227
Provider Name (Legal Business Name): WAYNE F YAKES, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 05/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 W HAMPDEN AVE STE 460
ENGLEWOOD CO
80110-2109
US

IV. Provider business mailing address

PO BOX 27499
DENVER CO
80227-0499
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-4280
  • Fax:
Mailing address:
  • Phone: 303-788-4280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number24847
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code281P00000X
TaxonomyChronic Disease Hospital
License Number24847
License Number StateCO

VIII. Authorized Official

Name: MR. WAYNE FRANCIS YAKES
Title or Position: MD
Credential: MD
Phone: 303-788-4280