Provider Demographics
NPI:1578673893
Name:YECKLEY, JAMES ALBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALBERT
Last Name:YECKLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22577
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31403-2577
Mailing Address - Country:US
Mailing Address - Phone:912-354-8866
Mailing Address - Fax:912-353-8460
Practice Address - Street 1:835 E 65TH ST
Practice Address - Street 2:SUITE 107
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4421
Practice Address - Country:US
Practice Address - Phone:912-354-8866
Practice Address - Fax:912-353-8460
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA17909207N00000X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000081991AMedicaid
GA000081991AMedicaid