Individual
ADAM J. YEAGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
11600 W 2ND PL, LAKEWOOD, CO 80228-1527
(720) 321-4161
(720) 321-4165
Mailing address
PO BOX 5788, DENVER, CO 80217-5788
(303) 202-1280
(303) 202-1281
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1533
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72155230
—
CO
01
—
P00417259
RR MEDICARE
CO
Enumeration date
12/05/2006
Last updated
08/14/2013
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