Organization
PERSON EMERGENCY PHYSICANS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY YARBOROUGH MD (MEDICAL DIRECTOR)
(843) 237-3378
Entity
Organization
Contact information
Practice address
615 RIDGE RD, ROXBORO, NC 27573-4629
(843) 237-3378
(843) 237-5073
Mailing address
PO BOX 30727, CHARLOTTE, NC 28230-0727
(843) 237-3378
(843) 237-5073
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0104J
BLUE CROSS BLUE SHIELD
NC
05
—
790104J
—
NC
01
—
CN7197
RAILROAD MEDICARE
NC
Enumeration date
04/25/2006
Last updated
03/17/2009
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