Provider Demographics
NPI:1891798898
Name:YARNELL, GEORGE L (DPM)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:L
Last Name:YARNELL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 N LANSDOWNE AVE
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-2205
Mailing Address - Country:US
Mailing Address - Phone:610-626-3338
Mailing Address - Fax:610-626-7542
Practice Address - Street 1:23 N LANSDOWNE AVE STE III
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050-2254
Practice Address - Country:US
Practice Address - Phone:610-626-3338
Practice Address - Fax:610-626-7542
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC-001368-L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10122Medicaid
PAP025769OtherADMINASTAR DEFENSE #
PA0032715000OtherPERSONAL CHOICE
PA19106Medicaid
PA0032715000OtherKEYSTONE HMO #
PA048613OtherPA BLUE SHIELD
PA31709Medicaid
PA0005003760001Medicaid
PAADMINASTAROtherPROVIDER COMMERCIAL #
PA30572Medicaid
PA0032715000OtherKEYSTONE HMO #
PA31709Medicaid