Provider Demographics
NPI:1215557145
Name:GEORGE L YARNELL, D.P.M.
Entity Type:Organization
Organization Name:GEORGE L YARNELL, D.P.M.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:L
Authorized Official - Last Name:YARNELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:610-626-3338
Mailing Address - Street 1:23 N LANSDOWNE AVE STE III
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-2254
Mailing Address - Country:US
Mailing Address - Phone:610-626-3338
Mailing Address - Fax:610-626-7542
Practice Address - Street 1:23 N LANSDOWNE AVE STE III
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050-2254
Practice Address - Country:US
Practice Address - Phone:610-626-3338
Practice Address - Fax:610-626-7542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA19106Medicaid
PA30572Medicaid
PA0032715000OtherBLUE SHIELD
PA31709Medicaid
PA0032715000OtherKEYSTONE HMO
PA00500376001Medicaid
P025769OtherADMINASTAR DEFENSE
PA003715000OtherKEYSTONE HMO
PA10122Medicaid