Provider Demographics
NPI:1154351005
Name:WILLIAM J. YARBROUGH, M.D., INC.
Entity type:Organization
Organization Name:WILLIAM J. YARBROUGH, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARILYNN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:HATA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-522-5055
Mailing Address - Street 1:1329 LUSITANA STREET
Mailing Address - Street 2:SUITE 602
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2431
Mailing Address - Country:US
Mailing Address - Phone:808-522-5055
Mailing Address - Fax:808-524-6306
Practice Address - Street 1:1329 LUSITANA STREET
Practice Address - Street 2:SUITE 602
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2431
Practice Address - Country:US
Practice Address - Phone:808-522-5055
Practice Address - Fax:808-524-6306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH53730Medicare ID - Type UnspecifiedGROUP NUMBER