Provider Demographics
NPI:1205855731
Name:YATES, RICHARD S (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:S
Last Name:YATES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4242 FARNAM ST
Mailing Address - Street 2:#470
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2806
Mailing Address - Country:US
Mailing Address - Phone:402-552-9875
Mailing Address - Fax:402-552-9876
Practice Address - Street 1:4242 FARNAM ST
Practice Address - Street 2:#470
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2806
Practice Address - Country:US
Practice Address - Phone:402-552-9875
Practice Address - Fax:402-552-9876
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE14757207RP1001X
IA29282207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEB67788Medicare UPIN