Provider Demographics
NPI:1467540880
Name:YEATES, JAMES JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JOSEPH
Last Name:YEATES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 LASKIN RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-6302
Mailing Address - Country:US
Mailing Address - Phone:757-227-5465
Mailing Address - Fax:757-227-5725
Practice Address - Street 1:1023 LASKIN RD
Practice Address - Street 2:SUITE 103
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-6302
Practice Address - Country:US
Practice Address - Phone:757-227-5465
Practice Address - Fax:757-227-5725
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001049111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
672033OtherACN
321807OtherMAMSI
VA009500669Medicaid
1024174OtherAMERICAN SPECIALTY HEALTH
VA308668OtherANTHEM BC/BS OF RICHMOND
U32369Medicare UPIN