Provider Demographics
NPI:1528165867
Name:YATES, DON A (DPM)
Entity type:Individual
Prefix:
First Name:DON
Middle Name:A
Last Name:YATES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:D
Other - Middle Name:ALDEN
Other - Last Name:YATES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:736 S 900 E
Mailing Address - Street 2:STE 101
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7001
Mailing Address - Country:US
Mailing Address - Phone:435-674-7444
Mailing Address - Fax:
Practice Address - Street 1:736 S 900 E
Practice Address - Street 2:STE 101
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7001
Practice Address - Country:US
Practice Address - Phone:435-674-7444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT89-105595-0501213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000010095Medicare PIN
UTU19511Medicare UPIN
UT3908710001Medicare NSC