MEDICARE: DR. JOHN D YEAST 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	207V00000X	Obstetrics & Gynecology Physician	R9E95	MO
2	207VM0101X	Maternal & Fetal Medicine Physician	R9E95	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00381054	OTHER	MO	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497754493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN D YEAST M.D.

Provider Business Mailing Address
First Line	:	901 E 104TH ST
Second Line	:	MAILSTOP 400N
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-4517
Country	:	US
Telephone Number	:	816-502-7000
Fax Number	:	816-932-7957

Provider Business Practice Location Address
First Line	:	4320 WORNALL RD
Second Line	:	SUITE 336
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-5941
Country	:	US
Telephone Number	:	816-932-6100
Fax Number	:	816-461-6586

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

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	11/22/2016

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Directions to “ DR. JOHN D YEAST M.D.” Practice Location

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