Individual
MR. WILFRED W YEARGAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1030 FAIRFAX PARK, TUSCALOOSA, AL 35406-2806
(205) 752-1584
(205) 752-9987
Mailing address
1030 FAIRFAX PARK, TUSCALOOSA, AL 35406-2806
(205) 752-1584
(205) 752-9987
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
3697
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000007147
—
AL
01
—
0923740001
MEDICARE DMERC
AL
01
—
407183036
MEDICARE RAILROAD
AL
01
—
51007147
BLUE CROSS
AL
Enumeration date
10/06/2005
Last updated
08/18/2011
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