Provider Demographics
NPI:1194986729
Name:PHILIP R. YARNELL, M.D., P.C.
Entity type:Organization
Organization Name:PHILIP R. YARNELL, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:R
Authorized Official - Last Name:YARNELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-809-9079
Mailing Address - Street 1:311 S WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-2636
Mailing Address - Country:US
Mailing Address - Phone:303-809-9079
Mailing Address - Fax:303-282-1091
Practice Address - Street 1:311 S WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2636
Practice Address - Country:US
Practice Address - Phone:303-809-9079
Practice Address - Fax:303-282-1091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01176684Medicaid
CO01176684Medicaid