Provider Demographics
NPI:1568642965
Name:JAMES E. YARBROUGH, OD PA
Entity Type:Organization
Organization Name:JAMES E. YARBROUGH, OD PA
Other - Org Name:LAURENS VISION AND CONTACT LENS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:YARBROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:864-984-6504
Mailing Address - Street 1:1010 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAURENS
Mailing Address - State:SC
Mailing Address - Zip Code:29360-2608
Mailing Address - Country:US
Mailing Address - Phone:864-984-6504
Mailing Address - Fax:864-984-6505
Practice Address - Street 1:1010 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:SC
Practice Address - Zip Code:29360-2608
Practice Address - Country:US
Practice Address - Phone:864-984-6504
Practice Address - Fax:864-984-6505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCL8123OtherRAIL ROAD MEDICARE GROUP
SC1656Medicare PIN
SCCL8123OtherRAIL ROAD MEDICARE GROUP