Provider Demographics
NPI:1033272117
Name:WHITEHEAD, BARRY H (OD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:H
Last Name:WHITEHEAD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2016 STONEHEATHER RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238-5815
Mailing Address - Country:US
Mailing Address - Phone:804-741-8532
Mailing Address - Fax:
Practice Address - Street 1:1601 WILLOW LAWN DR
Practice Address - Street 2:SUITE 254
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3427
Practice Address - Country:US
Practice Address - Phone:804-288-2202
Practice Address - Fax:804-282-9155
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0601000589152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist