Dr Gregory M Yasuda, MD | |
75 Yellow Creek Rd Ste 101, Evanston, WY 82930-5205 | |
(307) 789-7777 | |
(307) 789-8888 |
Full Name | Dr Gregory M Yasuda |
---|---|
Gender | Male |
Speciality | Surgery |
Location | 75 Yellow Creek Rd Ste 101, Evanston, Wyoming |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1841391349 | NPI | - | NPPES |
109094100 | Medicaid | WY | |
310965 | Other | WY | BLUE CROSS/BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 5379A (Wyoming) | Primary |
Entity Name | Evanston Clinic Corp |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013916519 PECOS PAC ID: 8325038094 Enrollment ID: O20040514000481 |
Mailing Address | Practice Location Address |
---|---|
Dr Gregory M Yasuda, MD 711 Onyx St, Kemmerer, WY 83101-3214 Ph: (307) 789-7777 | Dr Gregory M Yasuda, MD 75 Yellow Creek Rd Ste 101, Evanston, WY 82930-5205 Ph: (307) 789-7777 |
Dr. Jared Breck Barton, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 191 Overthrust Rd, Evanston, WY 82930 Phone: 307-789-8721 Fax: 307-789-8664 | |
Paul T. Gustafson, D.O. Surgery Medicare: Medicare Enrolled Practice Location: 196 Arrowhead Dr, Ste 9, Evanston, WY 82930 Phone: 307-783-8280 | |
Ian James Kendrick, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 190 Arrowhead Dr, Evanston, WY 82930 Phone: 307-783-8255 Fax: 307-783-8167 |