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General NPI Number Information
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NPI Number | 1205874336
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Entity Type | Organization
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Legal Business Name | YATES EMERGENCY PHYSICIANS
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 517 N MAIN ST
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City | ANNA
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State | IL
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Zip | 62906-1668
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Country | US
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Telephone | 618-833-4511
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Fax | 618-833-8481
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Provider Business Mailing Address
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Address Line | PO BOX 8090
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City | PHILADELPHIA
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State | PA
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Zip | 19101-8090
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Country | US
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Telephone | 800-732-1066
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Fax | 630-941-4333
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. DOUGLAS P. WEBSTER
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Credential | D.O.
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Telephone | 800-732-1066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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