Provider Demographics
NPI:1841609682
Name:YANCEY, ASA GREENWOOD JR (MD)
Entity Type:Individual
Prefix:
First Name:ASA
Middle Name:GREENWOOD
Last Name:YANCEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6851 SOUTH HOLLY CIRCLE
Mailing Address - Street 2:SUITE 260
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1050
Mailing Address - Country:US
Mailing Address - Phone:303-740-0400
Mailing Address - Fax:303-770-1252
Practice Address - Street 1:6851 S HOLLY CIR
Practice Address - Street 2:SUITE 260
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1019
Practice Address - Country:US
Practice Address - Phone:303-740-0400
Practice Address - Fax:303-770-1252
Is Sole Proprietor?:No
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO294372084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
COE-78873Medicare UPIN