Provider Demographics
NPI:1003140963
Name:BARR, LESLIE ERIN (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:ERIN
Last Name:BARR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:ERIN
Other - Last Name:BLIHOVDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:805 N KENTUCKY AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-2022
Mailing Address - Country:US
Mailing Address - Phone:417-256-2111
Mailing Address - Fax:417-256-4858
Practice Address - Street 1:805 N KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-2022
Practice Address - Country:US
Practice Address - Phone:417-256-2111
Practice Address - Fax:417-256-4858
Is Sole Proprietor?:No
Enumeration Date:2009-09-25
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME103823207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2009039074OtherMISSOURI MEDICAL LICENSE
MO1003140963Medicaid
FLME103823OtherFLORIDA MEDICAL LICENSE
FLME103823OtherFLORIDA MEDICAL LICENSE