Provider Demographics
NPI:1467646992
Name:YADKIN VALLEY SURGICAL, PLLC
Entity Type:Organization
Organization Name:YADKIN VALLEY SURGICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BARRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-835-2349
Mailing Address - Street 1:201B ELDON PARKS DR
Mailing Address - Street 2:
Mailing Address - City:ELKIN
Mailing Address - State:NC
Mailing Address - Zip Code:28621-0000
Mailing Address - Country:US
Mailing Address - Phone:336-835-2349
Mailing Address - Fax:336-835-2541
Practice Address - Street 1:201B ELDON PARKS DR
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-0000
Practice Address - Country:US
Practice Address - Phone:336-835-2349
Practice Address - Fax:336-835-2541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200501815208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty