Provider Demographics
NPI:1760721971
Name:DAVID A. YATES & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DAVID A. YATES & ASSOCIATES, LLC
Other - Org Name:JP&O PROSTHETIC & ORTHOTIC LABORATORY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROB
Authorized Official - Middle Name:A
Authorized Official - Last Name:YATES
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:870-932-6436
Mailing Address - Street 1:PO BOX 9303
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72403-9303
Mailing Address - Country:US
Mailing Address - Phone:870-932-6436
Mailing Address - Fax:
Practice Address - Street 1:820 PROFESSIONAL ACRES DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4340
Practice Address - Country:US
Practice Address - Phone:870-932-6436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-07
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR0246660006Medicare NSC