Provider Demographics
NPI:1083896583
Name:D ALDEN YATES DPM PC
Entity Type:Organization
Organization Name:D ALDEN YATES DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RENAE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-674-7444
Mailing Address - Street 1:736 S 900 E
Mailing Address - Street 2:STE 101
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7001
Mailing Address - Country:US
Mailing Address - Phone:435-674-7444
Mailing Address - Fax:
Practice Address - Street 1:736 S 900 E
Practice Address - Street 2:STE 101
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7001
Practice Address - Country:US
Practice Address - Phone:435-674-7444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT3908710001Medicare NSC
UT000010095Medicare PIN