MEDICARE: LAURA J YARD M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LA0401X	Addiction Medicine (Anesthesiology) Physician	35.135244	OH
2	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician	MD466715	PA
3	207RA0401X	Addiction Medicine (Internal Medicine) Physician	ME68224	FL

General Provider Information

NPI Number	:	1487651964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA J YARD M.D

Provider Business Mailing Address
First Line	:	6124 S TAMIAMI TRL
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34231-4029
Country	:	US
Telephone Number	:	941-925-6672
Fax Number	:	513-204-3476

Provider Business Practice Location Address
First Line	:	6124 S TAMIAMI TRL
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34231-4029
Country	:	US
Telephone Number	:	941-925-6672
Fax Number	:	513-204-3476

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	01/12/2022

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