Basic Information
Provider Information
NPI: 1134197361
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YARBROUGH
FirstName: RANDY
MiddleName: JAMES
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2895
Address2:  
City: CULLMAN
State: AL
PostalCode: 350562895
CountryCode: US
TelephoneNumber: 2567355072
FaxNumber: 2567372584
Practice Location
Address1: 1948 AL HIGHWAY 157 STE 330
Address2:  
City: CULLMAN
State: AL
PostalCode: 350580643
CountryCode: US
TelephoneNumber: 2567355277
FaxNumber: 2562038626
Other Information
ProviderEnumerationDate: 03/14/2006
LastUpdateDate: 09/23/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/23/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X12690ALY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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