Basic Information
| Provider Information | |||||||||
| NPI: | 1073827036 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | YEAMAN SIGNATURE HEALTH CLINIC, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1330 | ||||||||
| Address2: | |||||||||
| City: | NORMAN | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730701330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053104300 | ||||||||
| FaxNumber: | 4053104311 | ||||||||
| Practice Location | |||||||||
| Address1: | 809 N FINDLAY AVE | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | NORMAN | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730716412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053104300 | ||||||||
| FaxNumber: | 4053104311 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2010 | ||||||||
| LastUpdateDate: | 04/19/2012 | ||||||||
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| AuthorizedOfficialLastName: | YEAMAN | ||||||||
| AuthorizedOfficialFirstName: | BRIAN | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 4053104300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.