Individual
DR. FERDINAND DOMENIC YATES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2000 PROFESSIONAL WAY, #200, WOODSTOCK, GA 30188-4093
(770) 517-0250
(770) 517-0260
Mailing address
2000 PROFESSIONAL WAY, #200, WOODSTOCK, GA 30188-4093
(770) 517-0250
(770) 517-0260
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
73676
GA
2080A0000X
Pediatric Adolescent Medicine Physician
140477-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003169014A
—
GA
05
—
00669374
—
NY
Enumeration date
06/09/2006
Last updated
05/03/2016
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