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NPI Code Detail

MEDICARE: DR. JOHN PATRICK YEATTS MD, MPH

MEDICARE: DR. JOHN PATRICK YEATTS MD, MPH
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1679830640
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN PATRICK YEATTS MD, MPH
Provider Business Mailing Address
First Line : 444 S BLOUNT ST STE 326
Second Line :
City : RALEIGH
State : NC
Zip : 27601-2087
Country : US
Telephone Number : 919-279-5097
Fax Number :
Provider Business Practice Location Address
First Line : 2301 ERWIN RD
Second Line :
City : DURHAM
State : NC
Zip : 27705-4699
Country : US
Telephone Number : 919-668-6577
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2012
Last Update Date : 04/16/2012

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