Provider Demographics
NPI:1851887186
Name:YATES, FREDERICK JAMES III (CASE MANAGER)
Entity Type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:JAMES
Last Name:YATES
Suffix:III
Gender:M
Credentials:CASE MANAGER
Other - Prefix:MR
Other - First Name:FREDERICK
Other - Middle Name:JAMES
Other - Last Name:YATES
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1336 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2081
Mailing Address - Country:US
Mailing Address - Phone:614-914-8781
Mailing Address - Fax:
Practice Address - Street 1:1336 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2081
Practice Address - Country:US
Practice Address - Phone:614-914-8781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator