=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497754493
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN D YEAST M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/20/2005
-----------------------------------------------------
Last Update Date | 11/22/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4320 WORNALL RD SUITE 336
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64111-5941
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-932-6100
-----------------------------------------------------
Fax | 816-461-6586
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 901 E 104TH ST MAILSTOP 400N
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64131-4517
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-502-7000
-----------------------------------------------------
Fax | 816-932-7957
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | R9E95
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207VM0101X
-----------------------------------------------------
Taxonomy Name | Maternal & Fetal Medicine Physician
-----------------------------------------------------
License Number | R9E95
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------