Provider Demographics
NPI:1457589939
Name:YARBROUGH, CHESTER KOSSMAN (MD)
Entity type:Individual
Prefix:
First Name:CHESTER
Middle Name:KOSSMAN
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 1:1248 HUFFMAN MILL RD # 101
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8700
Mailing Address - Country:US
Mailing Address - Phone:336-890-3390
Mailing Address - Fax:336-890-3391
Practice Address - Street 1:1248 HUFFMAN MILL RD STE 101
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8700
Practice Address - Country:US
Practice Address - Phone:336-890-3390
Practice Address - Fax:336-890-3391
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-00526207T00000X
MO2009014359207T00000X
UT9697221-1205207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2013027013OtherMO BOARD OF HEALING ARTS
UT9697221-1205OtherSTATE OF UTAH