Provider Demographics
NPI:1073827036
Name:YEAMAN SIGNATURE HEALTH CLINIC, INC.
Entity Type:Organization
Organization Name:YEAMAN SIGNATURE HEALTH CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:YEAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-310-4300
Mailing Address - Street 1:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-1330
Mailing Address - Country:US
Mailing Address - Phone:405-310-4300
Mailing Address - Fax:405-310-4311
Practice Address - Street 1:809 N FINDLAY AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6412
Practice Address - Country:US
Practice Address - Phone:405-310-4300
Practice Address - Fax:405-310-4311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-02
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOKA102174Medicare PIN