Provider Demographics
NPI:1386616936
Name:YAO, ERIC S (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:S
Last Name:YAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1377 N 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:STAYTON
Mailing Address - State:OR
Mailing Address - Zip Code:97383-2037
Mailing Address - Country:US
Mailing Address - Phone:503-769-8470
Mailing Address - Fax:503-769-9860
Practice Address - Street 1:1377 N 10TH AVE
Practice Address - Street 2:
Practice Address - City:STAYTON
Practice Address - State:OR
Practice Address - Zip Code:97383-2037
Practice Address - Country:US
Practice Address - Phone:503-769-8470
Practice Address - Fax:503-769-9860
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI42806-020207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORMD27872OtherMEDICAL LICENSE
OR500604576Medicaid
OR163096Medicare PIN