Provider Demographics
NPI:1275709958
Name:YATES, CHARLES W (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:W
Last Name:YATES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:705 RILEY HOSPITAL DR
Mailing Address - Street 2:SUITE 0860
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5109
Mailing Address - Country:US
Mailing Address - Phone:317-630-8970
Mailing Address - Fax:317-630-8958
Practice Address - Street 1:550 UNIVERSITY BOULEVARD
Practice Address - Street 2:SUITE 3170
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5159
Practice Address - Country:US
Practice Address - Phone:317-948-3226
Practice Address - Fax:317-944-2443
Is Sole Proprietor?:No
Enumeration Date:2008-05-02
Last Update Date:2021-01-13
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Provider Licenses
StateLicense IDTaxonomies
OH35.092162207YX0901X
IN01067786A207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200984050Medicaid
INM400020943Medicare PIN