Dr Ferdinand Domenic Yates Jr, MD | |
2000 Professional Way, #200, Woodstock, GA 30188-4093 | |
(770) 517-0250 | |
(770) 517-0260 |
Full Name | Dr Ferdinand Domenic Yates Jr |
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Gender | Male |
Speciality | Pediatrics |
Location | 2000 Professional Way, Woodstock, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1154362366 | NPI | - | NPPES |
00669374 | Medicaid | NY | |
003169014A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080A0000X | Pediatrics - Adolescent Medicine | 140477-1 (New York) | Secondary |
208000000X | Pediatrics | 73676 (Georgia) | Primary |
Entity Name | Neighborhood Health Center Of Wny, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881789014 PECOS PAC ID: 5193794972 Enrollment ID: O20040928001235 |
Mailing Address | Practice Location Address |
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Dr Ferdinand Domenic Yates Jr, MD 2000 Professional Way, #200, Woodstock, GA 30188-4093 Ph: (770) 517-0250 | Dr Ferdinand Domenic Yates Jr, MD 2000 Professional Way, #200, Woodstock, GA 30188-4093 Ph: (770) 517-0250 |
Dr. Romualda S Klicius, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2230 Towne Lake Pkwy, Building 300, Suite 100, Woodstock, GA 30189 Phone: 770-517-1900 Fax: 770-926-3215 | |
Jordana A Heaven, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2000 Professional Way, Ste 200, Woodstock, GA 30188 Phone: 770-517-0250 Fax: 770-517-0260 | |
Whitney Lauren Fose, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1007 Weatherstone Pkwy Ste 210, Woodstock, GA 30188 Phone: 470-203-0006 | |
Dr. Mohamed Midani, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 145 N Medical Pkwy, Woodstock, GA 30189 Phone: 770-517-1900 | |
Thanhtam Thi Le, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2000 Professional Way Ste 200, Woodstock, GA 30188 Phone: 770-517-0250 | |
Dr. Timothy Christopher Lorenz, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 155 River Park Xing, Woodstock, GA 30188 Phone: 770-924-9858 Fax: 770-924-9946 |