Provider Demographics
NPI:1225124324
Name:YEAKEY, PATRICK C (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:C
Last Name:YEAKEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6065
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:HI
Mailing Address - Zip Code:96737-6065
Mailing Address - Country:US
Mailing Address - Phone:808-939-8100
Mailing Address - Fax:808-829-3672
Practice Address - Street 1:95-6040 MAMALAHOA HWY.
Practice Address - Street 2:
Practice Address - City:NAALEHU
Practice Address - State:HI
Practice Address - Zip Code:96772
Practice Address - Country:US
Practice Address - Phone:808-939-8100
Practice Address - Fax:808-829-3672
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD23238207Q00000X
HI20741207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORH05564Medicare UPIN