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General NPI Number Information
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NPI Number | 1124179106
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Entity Type | Organization
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Legal Business Name | DAVID L. YEAGER, MD PC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 12/13/2010
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Provider Practice Location Address
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Address Line | 346 POMFRET ST
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City | PUTNAM
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State | CT
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Zip | 06260-1871
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Country | US
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Telephone | 860-928-0815
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Fax | 860-928-4514
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Provider Business Mailing Address
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Address Line | 346 POMFRET ST
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City | PUTNAM
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State | CT
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Zip | 06260-1871
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Country | US
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Telephone | 860-928-0815
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Fax | 860-928-4514
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. DAVID L. YEAGER
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Credential | M.D.
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Telephone | 860-928-0815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 016964
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License Number State | CT
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