Provider Demographics
NPI:1003070889
Name:DAVID A. YATES & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DAVID A. YATES & ASSOCIATES, LLC
Other - Org Name:DAVID A. YATES & ASSOCIATES, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:YATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-932-6436
Mailing Address - Street 1:PO BOX 9303
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72403-9303
Mailing Address - Country:US
Mailing Address - Phone:870-932-6436
Mailing Address - Fax:
Practice Address - Street 1:1699 HARRISON ST
Practice Address - Street 2:SUITE E
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7302
Practice Address - Country:US
Practice Address - Phone:870-698-0991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-11
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR178747716Medicaid
AR0246660004Medicare NSC