Provider Demographics
NPI:1265407894
Name:YEAKLEY, JOHN C (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:YEAKLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6939
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-0939
Mailing Address - Country:US
Mailing Address - Phone:402-436-2000
Mailing Address - Fax:402-436-2090
Practice Address - Street 1:6900 A ST
Practice Address - Street 2:STE 100
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4120
Practice Address - Country:US
Practice Address - Phone:402-436-2000
Practice Address - Fax:402-436-2090
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12345207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1297OtherMIDLANDS CHOICE
NE200026550OtherRAILROAD MEDICARE
NE91177983268510A003OtherTRI CARE
NE31781OtherBCBS OF NEBRASKA
NE268500Medicare PIN
B67713Medicare UPIN