Provider Demographics
NPI:1346253994
Name:YARBROUGH, ALEX A (DO)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:A
Last Name:YARBROUGH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:101 W UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-3981
Mailing Address - Country:US
Mailing Address - Phone:217-366-6162
Mailing Address - Fax:217-366-5642
Practice Address - Street 1:3101 FIELDS SOUTH DR
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61822-3743
Practice Address - Country:US
Practice Address - Phone:217-366-6162
Practice Address - Fax:217-366-5642
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2025-01-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036116115207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL203979019OtherMEDICARE PTAN