Organization
ASSOCIATION OF SPECIALTY PHYSICIANS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL DALE YAKISH M.D. (PRESIDENT)
(724) 775-4242
Entity
Organization
Contact information
Practice address
1030 BEANER HOLLOW RD, BEAVER, PA 15009-9723
(724) 775-4242
(724) 775-4960
Mailing address
1030 BEANER HOLLOW RD, BEAVER, PA 15009-9723
(724) 775-4242
(724) 775-4960
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015810470017
—
PA
Enumeration date
09/27/2005
Last updated
06/30/2015
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