Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 10775 | WV |
N | 207ND0900X | Dermatopathologist | 10775 | WV |
NPI | 1356331508 |
---|---|
Provider Name | Charles L Yarbrough |
First Address | Huntington, WV 25701-3722 |
Second Address | Huntington, WV 25701-3722 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2005 |
Last Update Date | 25/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0070244000 | (05) | WV |