Provider Demographics
NPI:1134197361
Name:YARBROUGH, RANDY JAMES (MD)
Entity type:Individual
Prefix:
First Name:RANDY
Middle Name:JAMES
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 2895
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35056-2895
Mailing Address - Country:US
Mailing Address - Phone:256-735-5072
Mailing Address - Fax:256-737-2584
Practice Address - Street 1:1948 AL HIGHWAY 157 STE 330
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-0643
Practice Address - Country:US
Practice Address - Phone:256-735-5277
Practice Address - Fax:256-203-8626
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12690207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL138610Medicaid