Healthcare Provider Details

I. General information

NPI: 1750567087
Provider Name (Legal Business Name): MARGARET R. YEARWOOD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2008
Last Update Date: 01/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 SW 2ND AVE
OCALA FL
34471-0926
US

IV. Provider business mailing address

1040 SW 2ND AVE
OCALA FL
34471-0926
US

V. Phone/Fax

Practice location:
  • Phone: 352-732-3005
  • Fax: 352-732-9828
Mailing address:
  • Phone: 352-732-3005
  • Fax: 352-732-9828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA910448
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: