Provider Demographics
NPI:1003876731
Name:BARTON, BRUCE W (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:W
Last Name:BARTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:301 4TH STREET
Mailing Address - Street 2:BOX 30152
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-8421
Mailing Address - Country:US
Mailing Address - Phone:318-473-9701
Mailing Address - Fax:318-473-9705
Practice Address - Street 1:201 4TH ST STE 3D
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8421
Practice Address - Country:US
Practice Address - Phone:318-473-9701
Practice Address - Fax:318-473-9705
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-25
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017897207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1366978Medicaid
P00419414OtherRAILROAD MEDICARE
LA53030Medicare PIN
P00419414OtherRAILROAD MEDICARE