MEDICARE: TIMOTHY YARBORO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0101034008	VA

General Provider Information

NPI Number	:	1841388600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY YARBORO M.D.

Provider Business Mailing Address
First Line	:	12950 OAK LAWN PL
Second Line	:
City	:	HERNDON
State	:	VA
Zip	:	20171-2267
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 S WALTER REED DR
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22204-2308
Country	:	US
Telephone Number	:	703-228-5587
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	07/08/2007

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