Healthcare Provider Details

I. General information

NPI: 1730573627
Provider Name (Legal Business Name): THERESA YARBROUGH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2015
Last Update Date: 11/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 S UNIVERSITY BLVD STE 6000-A
MOBILE AL
36608-3042
US

IV. Provider business mailing address

2451 FILLINGIM ST # 7TH
MOBILE AL
36617-2238
US

V. Phone/Fax

Practice location:
  • Phone: 251-660-5787
  • Fax: 251-660-5559
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35708
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: