Provider Demographics
NPI:1386220648
Name:YEAGER OCULAR PROSTHETICS, LLC
Entity Type:Organization
Organization Name:YEAGER OCULAR PROSTHETICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HILLARY
Authorized Official - Middle Name:
Authorized Official - Last Name:YEAGER
Authorized Official - Suffix:
Authorized Official - Credentials:BCO, BADO
Authorized Official - Phone:319-337-9724
Mailing Address - Street 1:2050 KEOKUK ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-4551
Mailing Address - Country:US
Mailing Address - Phone:319-337-9724
Mailing Address - Fax:319-337-5445
Practice Address - Street 1:2050 KEOKUK ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-4551
Practice Address - Country:US
Practice Address - Phone:319-337-9724
Practice Address - Fax:319-337-5445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-18
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
17-387OtherNEBO