Individual
GLENN A YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1722 PINE ST, SUITE 309, MONTGOMERY, AL 36106-1103
(334) 262-0342
(334) 262-0390
Mailing address
1722 PINE ST, SUITE 309, MONTGOMERY, AL 36106-1103
(334) 262-0342
(334) 262-0390
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
8474
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8474
STATE LICENSE
AL
Enumeration date
11/02/2005
Last updated
11/16/2012
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