Individual
DR. ANNE B. YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5249
Mailing address
2500 N STATE ST, DEPT. OF PEDIATRICS, JACKSON, MS 39216-4500
(601) 984-5249
Taxonomy
Speciality
Code
Description
License number
State
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
10760
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00017885
—
MS
05
—
1927325
—
LA
01
—
512I370058
MEDICARE PTAN
MS
Enumeration date
06/22/2006
Last updated
06/14/2012
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