Provider Demographics
NPI:1669436937
Name:YAO, EVELINE FAITH (MD)
Entity type:Individual
Prefix:DR
First Name:EVELINE
Middle Name:FAITH
Last Name:YAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EVELINE
Other - Middle Name:FAITH
Other - Last Name:YAO-TIU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1926 KADIMA CIR
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-7413
Mailing Address - Country:US
Mailing Address - Phone:850-863-1270
Mailing Address - Fax:
Practice Address - Street 1:595 INDEPENDENCE RD
Practice Address - Street 2:
Practice Address - City:HURLBURT FIELD
Practice Address - State:FL
Practice Address - Zip Code:32544-5604
Practice Address - Country:US
Practice Address - Phone:850-881-5152
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01051794A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine