Provider Demographics
NPI:1790843852
Name:GERALD R YARNELL MD INC
Entity Type:Organization
Organization Name:GERALD R YARNELL MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:YARNELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-786-4341
Mailing Address - Street 1:468 E NATIONAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-1216
Mailing Address - Country:US
Mailing Address - Phone:317-786-4341
Mailing Address - Fax:317-783-7043
Practice Address - Street 1:468 E NATIONAL AVENUE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-1216
Practice Address - Country:US
Practice Address - Phone:317-786-4341
Practice Address - Fax:317-783-7043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01022396A207L00000X, 207LP2900X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B28035Medicare UPIN
IN038660Medicare ID - Type Unspecified