Provider Demographics
NPI:1255433512
Name:YEATS, JAMES F (DDS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:F
Last Name:YEATS
Suffix:
Gender:M
Credentials:DDS
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 96
Mailing Address - Street 2:
Mailing Address - City:CATOOSA
Mailing Address - State:OK
Mailing Address - Zip Code:74015-0096
Mailing Address - Country:US
Mailing Address - Phone:918-266-6470
Mailing Address - Fax:918-266-6473
Practice Address - Street 1:1755 NORTH HIGHWAY 66
Practice Address - Street 2:STE C
Practice Address - City:CATOOSA
Practice Address - State:OK
Practice Address - Zip Code:74015
Practice Address - Country:US
Practice Address - Phone:918-266-6470
Practice Address - Fax:918-266-6473
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK38681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice