Provider Demographics
NPI:1861070815
Name:YEATTS, NICHOLAS COCOROS (MD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:COCOROS
Last Name:YEATTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIV CINCINNATI DEPT ANESTHESIOLOGY
Mailing Address - Street 2:3188 BELLEVUE AVE
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219
Mailing Address - Country:US
Mailing Address - Phone:513-558-4206
Mailing Address - Fax:513-558-3474
Practice Address - Street 1:234 GOODMAN STREET
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-0796
Practice Address - Country:US
Practice Address - Phone:513-558-6356
Practice Address - Fax:513-558-3474
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.251015207L00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program