Individual
LEROY L YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3170 E 53RD ST, DAVENPORT, IA 52807-3864
(563) 275-4701
Mailing address
3170 E 53RD ST, DAVENPORT, IA 52807-3864
(563) 275-4701
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
27540
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
075592
HEALTH ALLIANCE
—
05
—
1064535
—
IA
01
—
202030
IOWA HEALTH SOLUTIONS
—
01
—
47368
WELLMARK HEALTH PLANS
—
01
—
4796890005
DMERC
—
05
—
525525902
—
IL
01
—
IA01C2
JOHN DEERE HEALTH PLAN
—
Enumeration date
06/24/2005
Last updated
08/31/2012
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