Provider Demographics
NPI:1629271168
Name:SUSAN M. YEOMANS, M.D., P.C.
Entity Type:Organization
Organization Name:SUSAN M. YEOMANS, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:YEOMANS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-481-0815
Mailing Address - Street 1:65 BOSTON POST RD W STE 250
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-1878
Mailing Address - Country:US
Mailing Address - Phone:508-481-0815
Mailing Address - Fax:508-481-0820
Practice Address - Street 1:65 BOSTON POST RD W STE 250
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-1878
Practice Address - Country:US
Practice Address - Phone:508-481-0815
Practice Address - Fax:508-481-0820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59025207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9750070Medicaid
MA9900243OtherFALLON COMM HEALTH
MAAA27711OtherHARVARD PILGRIM
MA35481118OtherCIGNA
MA637385OtherTUFTS
MAAS23327700001OtherCIGNA CT GENERAL
MAM18929OtherBLUE CROSS/BLUE SHIELD
MAM18929OtherBLUE CROSS/BLUE SHIELD
MA35481118OtherCIGNA
MA637385OtherTUFTS
MAM18929OtherBLUE CROSS/BLUE SHIELD