Provider Demographics
NPI:1326058611
Name:YARBROUGH, TERRY PICKNEY (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:PICKNEY
Last Name:YARBROUGH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3300 HIGH ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-3321
Mailing Address - Country:US
Mailing Address - Phone:757-393-0047
Mailing Address - Fax:757-393-0743
Practice Address - Street 1:3300 HIGH ST
Practice Address - Street 2:SUITE 6
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23707-3321
Practice Address - Country:US
Practice Address - Phone:757-393-0047
Practice Address - Fax:757-393-0743
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2010-03-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101017535207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA014956OtherANTHEM BC BS
VA22114OtherOPTIMA HEATH
VA014956OtherANTHEM BC BS
VA110050544Medicare ID - Type UnspecifiedRAILROAD MEDICARE
VI111950712Medicare ID - Type Unspecified