Individual
MISS KIMBERLY A YEATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1913 HIGHWAY 45 N, COLUMBUS, MS 39705-1950
(601) 917-0667
Mailing address
834 HIGHWAY 12 W # 109, STARKVILLE, MS 39759-3582
(601) 917-0667
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
782
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
BLUE CROSS
MS
05
—
009912502
—
AL
05
—
09172334
—
MS
05
—
104290
—
AL
05
—
104442
—
AL
01
—
51593508
BLUE CROSS - BUTLER LOCATION
AL
01
—
51593510
BLUE CROSS - LIVINGSTON LOCATION
AL
01
—
73104815
BLUE CROSS BLUE SHIELD OF ALABAMA
MS
01
—
P00444208
RAILROAD MEDICARE
MS
Enumeration date
08/01/2007
Last updated
12/10/2021
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