Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 15172R | LA |
Y | 207Q00000X | Family Doctor | 15172R | LA |
NPI | 1013920875 |
---|---|
Provider Name | Dr. William Todd Yates |
First Address | Monroe, LA 71202-6400 |
Second Address | Monroe, LA 71202-6400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 17/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1159654 | (05) | LA |
H88648 | (02) | LA |