Healthcare Provider Details

I. General information

NPI: 1144812165
Provider Name (Legal Business Name): TYLER HARRIS YEOMANS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2021
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 HOSPITAL DR
MACON GA
31217-3838
US

IV. Provider business mailing address

350 HOSPITAL DR
MACON GA
31217-3838
US

V. Phone/Fax

Practice location:
  • Phone: 478-751-0367
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number102938
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberP032535
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: