Provider Demographics
NPI:1407980949
Name:IAN F YEATS M.D. CHARTERED
Entity Type:Organization
Organization Name:IAN F YEATS M.D. CHARTERED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:YEATS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:620-624-0142
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:LIBERAL
Mailing Address - State:KS
Mailing Address - Zip Code:67905-0188
Mailing Address - Country:US
Mailing Address - Phone:620-624-0142
Mailing Address - Fax:620-624-2660
Practice Address - Street 1:1411 W 15TH ST STE 102
Practice Address - Street 2:
Practice Address - City:LIBERAL
Practice Address - State:KS
Practice Address - Zip Code:67901-2285
Practice Address - Country:US
Practice Address - Phone:620-624-0142
Practice Address - Fax:620-624-2660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS053833Medicare ID - Type Unspecified