Provider Demographics
NPI:1538290689
Name:YAGER, MICHAEL JOHN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JOHN
Last Name:YAGER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6270 S RIVERS END RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:UT
Mailing Address - Zip Code:84121-7909
Mailing Address - Country:US
Mailing Address - Phone:801-520-1657
Mailing Address - Fax:
Practice Address - Street 1:TSAILE HEALTH CENTER NAVAJO RTE 64&12
Practice Address - Street 2:
Practice Address - City:TSAILE
Practice Address - State:AZ
Practice Address - Zip Code:86556-0000
Practice Address - Country:US
Practice Address - Phone:928-724-3600
Practice Address - Fax:928-724-3786
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT276911-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant