Provider Demographics
NPI:1104297449
Name:YEATTS, CECIL GREY III (AUD)
Entity type:Individual
Prefix:DR
First Name:CECIL
Middle Name:GREY
Last Name:YEATTS
Suffix:III
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 JARRETT WHITE RD
Mailing Address - Street 2:
Mailing Address - City:TRIPLER AMC
Mailing Address - State:HI
Mailing Address - Zip Code:96859-5001
Mailing Address - Country:US
Mailing Address - Phone:808-433-2460
Mailing Address - Fax:808-433-1558
Practice Address - Street 1:DESMOND DOSS HEALTH CLINIC - AUDIOLOGY
Practice Address - Street 2:BLDG 687, 1ST FLOOR
Practice Address - City:SCHOFIELD BARRACKS
Practice Address - State:HI
Practice Address - Zip Code:96876
Practice Address - Country:US
Practice Address - Phone:808-433-8326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT145.0116325231H00000X
COAUD.0000941231H00000X
MI1601001048231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist