Individual
DR. GREGORY M YASUDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
75 YELLOW CREEK RD STE 101, EVANSTON, WY 82930-5205
(307) 789-7777
(307) 789-8888
Mailing address
711 ONYX ST, KEMMERER, WY 83101-3214
(307) 789-7777
(307) 789-8888
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5379A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109094100
—
WY
01
—
310965
BLUE CROSS/BLUE SHIELD
WY
Enumeration date
09/26/2006
Last updated
01/05/2012
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