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General NPI Number Information
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NPI Number | 1467002220
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Entity Type | Individual
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Provider Name | GREGORY ALAN YAGER
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Gender | Male
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Dates
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Enumeration Date | 09/13/2019
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Last Update Date | 09/20/2024
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Provider Practice Location Address
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Address Line | 500 W BURLEIGH BLVD
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City | TAVARES
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State | FL
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Zip | 32778-2400
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Country | US
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Telephone | 352-360-0023
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Fax |
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Provider Business Mailing Address
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Address Line | 750 N COMMONS DR STE 200
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City | AURORA
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State | IL
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Zip | 60504-7940
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Country | US
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Telephone | 630-303-5380
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Fax | 630-303-5385
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HDS001027
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | AS5537
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License Number State | FL
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