Physician Compare National (NPI:1821171836)

HEALTHCARE PROVIDER: MARK YEAKLEY MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1821171836
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4486634607
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120223000453
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	YEAKLEY
	Individual professional last name
Provider First Name	MARK
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
	Individual professional's medical school
Graduation Year	1976
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	7102 SHIPP RD
	Group Practice or individual's line 1 address
City	ROWLETT
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	750884226
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	451331
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	COON MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	451356
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MEMORIAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y