Provider Demographics
NPI:1477515336
Name:YAEGER, ERIC SCOTT (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:SCOTT
Last Name:YAEGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1213
Mailing Address - Country:US
Mailing Address - Phone:303-220-9948
Mailing Address - Fax:303-770-4389
Practice Address - Street 1:4950 S YOSEMITE ST
Practice Address - Street 2:F-345
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1349
Practice Address - Country:US
Practice Address - Phone:303-220-9948
Practice Address - Fax:303-770-4389
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO29092207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01290923Medicaid
CO284208Medicare PIN
CO01290923Medicaid