Provider Demographics
NPI:1184803645
Name:ERIC S YAEGER MD PC
Entity type:Organization
Organization Name:ERIC S YAEGER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:KOLSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-907-7779
Mailing Address - Street 1:PO BOX 4797
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80155-4797
Mailing Address - Country:US
Mailing Address - Phone:303-220-9948
Mailing Address - Fax:
Practice Address - Street 1:1920 HIGH ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1213
Practice Address - Country:US
Practice Address - Phone:303-220-9948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO29092208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC284208Medicare PIN
COF81638Medicare UPIN
COC284208Medicare Oscar/Certification