Healthcare Provider Details

I. General information

NPI: 1285019455
Provider Name (Legal Business Name): DAVID A. YATES & ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1641 GIBSON ST
WEST PLAINS MO
65775-1873
US

IV. Provider business mailing address

PO BOX 9303
JONESBORO AR
72403-9303
US

V. Phone/Fax

Practice location:
  • Phone: 417-257-0052
  • Fax:
Mailing address:
  • Phone: 870-932-6436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. ROB A YATES
Title or Position: PRESIDENT/CEO
Credential: CPO, LPO, FAAOP
Phone: 870-932-6436