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Individual

MARK WILLIAM YEAZEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1020 WEST BROADWAY, MINNEAPOLIS, MN 55411
(612) 302-8200
(612) 302-8275
Mailing address
720 WASHIGNTON AVE SE, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55414
(612) 884-0649

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31743
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01-03328
MEDICA - CHOICE
MN
01
092585
FAIRVIEW
MN
01
100588
UCARE
MN
01
1009362
PREFERREDONE
MN
05
570002700
MN
01
58D72YE
BLUE CROSS BLUE SHIELD
MN
01
768420
ARAZ
MN
01
HP17443
HEALTHPARTNERS
MN
Enumeration date
10/02/2006
Last updated
04/23/2012
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