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Organization

PIKE EMERGENCY MEDICINE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FRED K YATES MD (PRESIDENT)
(573) 754-5531
Entity
Organization

Contact information

Practice address
2305 GEORGIA ST, LOUISIANA, MO 63353-2559
(573) 754-5531
Mailing address
PO BOX 10739, DAYTONA BEACH, FL 32120-0739
(386) 274-7800
(386) 274-7801

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MO

Other

Enumeration date
12/04/2008
Last updated
05/04/2009
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