Provider Demographics
NPI:1558258681
Name:CENTER ONE MEDICAL OF LAFAYETTE
Entity type:Organization
Organization Name:CENTER ONE MEDICAL OF LAFAYETTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:YEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-214-3170
Mailing Address - Street 1:3900 CLARK RD STE L2
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-2375
Mailing Address - Country:US
Mailing Address - Phone:941-210-0248
Mailing Address - Fax:
Practice Address - Street 1:1700 KALISTE SALOOM RD STE 600
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6188
Practice Address - Country:US
Practice Address - Phone:337-252-3099
Practice Address - Fax:337-252-3098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-20
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty