Provider Demographics
NPI:1962746214
Name:YEAGER HARGIS, CAROL
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:YEAGER HARGIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 4 BOX 1107
Mailing Address - Street 2:
Mailing Address - City:COALGATE
Mailing Address - State:OK
Mailing Address - Zip Code:74538-9639
Mailing Address - Country:US
Mailing Address - Phone:940-447-5732
Mailing Address - Fax:
Practice Address - Street 1:RR 4 BOX 1107
Practice Address - Street 2:
Practice Address - City:COALGATE
Practice Address - State:OK
Practice Address - Zip Code:74538-9639
Practice Address - Country:US
Practice Address - Phone:940-447-5732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner