Provider Demographics
NPI:1245386945
Name:SUBAYTI, YAHYA (MD)
Entity Type:Individual
Prefix:
First Name:YAHYA
Middle Name:
Last Name:SUBAYTI
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 532893
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-2893
Mailing Address - Country:US
Mailing Address - Phone:904-805-1300
Mailing Address - Fax:904-805-1302
Practice Address - Street 1:631 R.B. WILSON DR.
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:TN
Practice Address - Zip Code:38344-1727
Practice Address - Country:US
Practice Address - Phone:731-267-0011
Practice Address - Fax:731-664-6590
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN17358207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3840625Medicaid
TN3840625Medicaid
TNE33759Medicare UPIN