Provider Demographics
NPI:1932162765
Name:YARBOROUGH, ELIZABETH GAIL (PT)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:GAIL
Last Name:YARBOROUGH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:BETSY
Other - Middle Name:GAIL
Other - Last Name:YARBOROUGH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:2278 ALBERT PIKE RD STE B
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-4157
Mailing Address - Country:US
Mailing Address - Phone:501-767-0808
Mailing Address - Fax:
Practice Address - Street 1:2278 ALBERT PIKE RD STE B
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-4157
Practice Address - Country:US
Practice Address - Phone:501-767-0808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT834225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR126340721Medicaid
AR5S695OtherBCBS