Provider Demographics
NPI:1275771651
Name:YARBROUGH, RAYMOND LEON
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:LEON
Last Name:YARBROUGH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2022 RICE ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-6148
Mailing Address - Country:US
Mailing Address - Phone:501-376-2267
Mailing Address - Fax:
Practice Address - Street 1:2022 RICE ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-6148
Practice Address - Country:US
Practice Address - Phone:501-376-2267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician