Healthcare Provider Details
I. General information
NPI: 1154397479
Provider Name (Legal Business Name): ADOLPH J YATES JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/27/2006
Last Update Date: 02/02/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5200 CENTRE AVE STE 415
PITTSBURGH PA
15232-1311
US
IV. Provider business mailing address
5200 CENTRE AVE STE 415
PITTSBURGH PA
15232-1311
US
V. Phone/Fax
- Phone: 412-802-4100
- Fax:
- Phone: 412-802-4100
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | MD424259 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0114X |
| Taxonomy | Adult Reconstructive Orthopaedic Surgery Physician |
| License Number | MD424259 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: