Organization
ATLANTA EMERGENCY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUBY F YATES MD (PRESIDENT)
(318) 347-6487
Entity
Organization
Contact information
Practice address
1007 S WILLIAM ST, ATLANTA, TX 75551-3245
(903) 799-3205
Mailing address
PO BOX 102002, ATLANTA, GA 30368-2002
(904) 805-1236
(916) 330-6930
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017SK
TEXAS BLUE CROSS
TX
05
—
206243201
—
TX
05
—
216516004
—
AR
Enumeration date
04/16/2009
Last updated
11/18/2016
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