Healthcare Provider Details

I. General information

NPI: 1497754493
Provider Name (Legal Business Name): JOHN D YEAST M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 11/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 WORNALL RD SUITE 336
KANSAS CITY MO
64111-5941
US

IV. Provider business mailing address

901 E 104TH ST MAILSTOP 400N
KANSAS CITY MO
64131-4517
US

V. Phone/Fax

Practice location:
  • Phone: 816-932-6100
  • Fax: 816-461-6586
Mailing address:
  • Phone: 816-502-7000
  • Fax: 816-932-7957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberR9E95
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberR9E95
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: