Provider Demographics
NPI:1578599437
Name:YARBROUGH, DONALD EUGENE (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:EUGENE
Last Name:YARBROUGH
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:PO BOX 1189
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97339-1189
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6 TSIENNETO RD STE 203
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1590
Practice Address - Country:US
Practice Address - Phone:603-434-7444
Practice Address - Fax:603-434-1733
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD26637208600000X
NH22089208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR278406Medicaid
ORR135168Medicare PIN
OR278406Medicaid
ORP00367475Medicare PIN