Basic Information
| Provider Information | |||||||||
| NPI: | 1336394410 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YEATES | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DO, MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 337 | ||||||||
| Address2: | |||||||||
| City: | LAYTON | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840410337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8017734840 | ||||||||
| FaxNumber: | 8015258151 | ||||||||
| Practice Location | |||||||||
| Address1: | 380 NORTH 400 WEST | ||||||||
| Address2: | TANNER MEMORIAL CLINIC | ||||||||
| City: | KAYSVILLE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8017734840 | ||||||||
| FaxNumber: | 8015258151 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2008 | ||||||||
| LastUpdateDate: | 08/02/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 4817885-1204 | UT | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.