Provider Demographics
NPI:1982711503
Name:YAKES, WAYNE F (MD)
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:F
Last Name:YAKES
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:PO BOX 27499
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80227-0499
Mailing Address - Country:US
Mailing Address - Phone:303-788-4280
Mailing Address - Fax:303-788-4412
Practice Address - Street 1:501 E HAMPDEN AVE
Practice Address - Street 2:STE 4600
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2702
Practice Address - Country:US
Practice Address - Phone:303-788-4280
Practice Address - Fax:303-788-4412
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO24847174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01248475Medicaid
CO01248475Medicaid
COE23276Medicare UPIN