Provider Demographics
NPI:1992857593
Name:YEAKEL, GREG (RPH)
Entity Type:Individual
Prefix:
First Name:GREG
Middle Name:
Last Name:YEAKEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ISU THOMAS B. THIELEN STUDENT HEALTH CENTER
Mailing Address - Street 2:UNION & SHELDON DR
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50011-2260
Mailing Address - Country:US
Mailing Address - Phone:515-294-5801
Mailing Address - Fax:515-294-7180
Practice Address - Street 1:ISU THOMAS B. THIELEN STUDENT HEALTH CENTER
Practice Address - Street 2:UNION & SHELDON DR
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50011-2260
Practice Address - Country:US
Practice Address - Phone:515-294-5801
Practice Address - Fax:515-294-7180
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA14684183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist