Provider Demographics
NPI:1952300675
Name:YEAGER, EARL STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:EARL
Middle Name:STEPHEN
Last Name:YEAGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15849
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-2549
Mailing Address - Country:US
Mailing Address - Phone:912-354-6303
Mailing Address - Fax:912-355-8655
Practice Address - Street 1:1326 EISENHOWER DR BLDG 2
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3928
Practice Address - Country:US
Practice Address - Phone:912-354-6303
Practice Address - Fax:912-355-8655
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA021614208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000203112BMedicaid
GA237201OtherBCBS
SCG55901Medicaid
GA407023875OtherRR MEDICARE
GA000203112BMedicaid
GA407023875OtherRR MEDICARE