Provider Demographics
NPI:1447033618
Name:YEATER, JUSTIN WILLIAM (MS)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:WILLIAM
Last Name:YEATER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 THOMAS LN STE 2D
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1419
Mailing Address - Country:US
Mailing Address - Phone:614-788-4653
Mailing Address - Fax:614-788-4650
Practice Address - Street 1:500 THOMAS LN STE 2D
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1419
Practice Address - Country:US
Practice Address - Phone:614-788-4653
Practice Address - Fax:614-788-4650
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS