Provider Demographics
NPI:1184885691
Name:YAEGE, ARLO H (DPM)
Entity type:Individual
Prefix:DR
First Name:ARLO
Middle Name:H
Last Name:YAEGE
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 1:352 MILUS ST
Mailing Address - Street 2:FOOT AND ANKLE CENTERS OF CHARLOTTE COUNTY
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-4552
Mailing Address - Country:US
Mailing Address - Phone:941-639-0025
Mailing Address - Fax:941-347-7271
Practice Address - Street 1:352 MILUS ST
Practice Address - Street 2:FOOT AND ANKLE CENTER OF CHARLOTTE COUNTY
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-4552
Practice Address - Country:US
Practice Address - Phone:941-639-0025
Practice Address - Fax:941-347-7271
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005945213ES0103X
FLPO3380213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
6500LOtherBLUE SHIELD
77160OtherGROUP MEDICARE PROVIDER #
0458500001Medicare NSC
77160OtherGROUP MEDICARE PROVIDER #