Individual
PAUL A YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
1300 JEFFERSON PARK AVE, CHARLOTTESVILLE, VA 22903-3363
(434) 924-5485
(434) 244-9436
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101242380
VA
207W00000X
Ophthalmology Physician
225177
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2106876
—
MA
01
—
J29226
BLUE CROSS BLUE SHIELD
—
Enumeration date
03/03/2006
Last updated
08/09/2023
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