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Individual

JOSEPH RANDALL YATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
3215 N NORTHHILLS BLVD, FAYETTEVILLE, AR 72703
(918) 664-9892
(918) 664-2521
Mailing address
PO BOX 1867, FAYETTEVILLE, AR 72702-1867
(918) 641-2551
(918) 392-2941

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R50192
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
177926001
AR
05
200246350A
OK
01
770193801
ARKANSAS BREASTCARE
AR
Enumeration date
04/13/2009
Last updated
08/04/2018
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