Individual
MARK J. YANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3400 OLD MILTON PKWY # C, STE 365, ALPHARETTA, GA 30005-3707
(404) 446-2400
(404) 446-2409
Mailing address
3400 OLD MILTON PKWY # C, STE 365, ALPHARETTA, GA 30005-3707
(404) 446-2400
(404) 446-2409
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
043827
GA
207Y00000X
Otolaryngology Physician
Primary
43827
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000749229H
—
GA
05
—
000749229W
—
GA
05
—
00749229H
—
GA
05
—
10034908
—
GA
05
—
296145
—
GA
01
—
3416408
AETNA
GA
Enumeration date
07/14/2005
Last updated
02/01/2017
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