Provider Demographics
NPI:1154350502
Name:YEAGER, STEPHEN D (DC)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:D
Last Name:YEAGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 N ALMA SCHOOL RD
Mailing Address - Street 2:SUITE #124
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-2489
Mailing Address - Country:US
Mailing Address - Phone:480-755-2277
Mailing Address - Fax:480-855-0815
Practice Address - Street 1:2330 N ALMA SCHOOL RD
Practice Address - Street 2:SUITE #124
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2489
Practice Address - Country:US
Practice Address - Phone:480-755-2277
Practice Address - Fax:480-855-0815
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0921111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1649476268OtherNPI
AZT42283Medicare UPIN
AZDC921Medicare ID - Type Unspecified