Individual
FREDERICK KETNER YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7939 HIGHWAY 165, COLUMBIA, LA 71418-3327
(318) 649-6106
Mailing address
PO BOX 6773, SHREVEPORT, LA 71136-6773
(318) 347-6487
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD.019642
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1929786
—
LA
Enumeration date
05/26/2006
Last updated
05/02/2014
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