Provider Demographics
NPI:1528028982
Name:YERBY, FREDERICK LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:LEE
Last Name:YERBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 TEMPLE AVE N
Mailing Address - Street 2:SUITE 6
Mailing Address - City:FAYETTE
Mailing Address - State:AL
Mailing Address - Zip Code:35555-1309
Mailing Address - Country:US
Mailing Address - Phone:205-932-7750
Mailing Address - Fax:205-932-6293
Practice Address - Street 1:1716 TEMPLE AVE N
Practice Address - Street 2:SUITE 6
Practice Address - City:FAYETTE
Practice Address - State:AL
Practice Address - Zip Code:35555-1309
Practice Address - Country:US
Practice Address - Phone:205-932-7750
Practice Address - Fax:205-932-6293
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15356207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000084451Medicaid
AL84451OtherBLUE CROSS/BLUE SHIELD
AL000084451Medicaid