Provider Demographics
NPI:1871588798
Name:YOE, WILLIAM T (OD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:T
Last Name:YOE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 13TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906-2066
Mailing Address - Country:US
Mailing Address - Phone:706-327-7269
Mailing Address - Fax:706-327-8524
Practice Address - Street 1:2404 13TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-2066
Practice Address - Country:US
Practice Address - Phone:706-327-7269
Practice Address - Fax:706-327-8524
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2008-01-25
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
GA1063T152W00000X, 152WC0802X, 152WL0500X, 152WP0200X, 152WS0006X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00296073BMedicaid
GA0716110001OtherDMERC
GA00296073Medicaid
GA0716110001OtherDMERC
GA00296073BMedicaid