Healthcare Provider Details

I. General information

NPI: 1265727655
Provider Name (Legal Business Name): ASSOCIATION OF SPECIALTY PHYSICIANS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2011
Last Update Date: 03/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48462 BELL SCHOOL RD
EAST LIVERPOOL OH
43920-9625
US

IV. Provider business mailing address

1030 BEANER HOLLOW RD
BEAVER PA
15009-9723
US

V. Phone/Fax

Practice location:
  • Phone: 724-775-4242
  • Fax: 724-775-4960
Mailing address:
  • Phone: 724-775-4242
  • Fax: 724-775-4960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SAMUEL DALE YAKISH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 724-775-4242