Individual
STACEY E BISHOP YEATMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2626 ALEXANDRIA PIKE, HIGHLAND HEIGHTS, KY 41076-1530
(859) 781-4111
(859) 441-5214
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 781-4111
(859) 441-5214
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39539
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2599997
—
OH
05
—
64109945
—
KY
01
—
P00243169
RAILROAD MEDICARE
KY
01
—
P00839854
RAILROAD MEDICARE
KY
Enumeration date
05/31/2006
Last updated
04/13/2020
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