Provider Demographics
NPI:1306941216
Name:YAGER, ALAN NEIL (MD APMC)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:NEIL
Last Name:YAGER
Suffix:
Gender:M
Credentials:MD APMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4224 HOUMA BLVD
Mailing Address - Street 2:STE 410
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2933
Mailing Address - Country:US
Mailing Address - Phone:504-888-8310
Mailing Address - Fax:504-889-1441
Practice Address - Street 1:4224 HOUMA BLVD
Practice Address - Street 2:STE 410
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2933
Practice Address - Country:US
Practice Address - Phone:504-888-8310
Practice Address - Fax:504-889-1441
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA019172207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAE40664Medicare UPIN