Provider Demographics
NPI:1073508750
Name:BARKSDALE, BYRON L (MD)
Entity Type:Individual
Prefix:DR
First Name:BYRON
Middle Name:L
Last Name:BARKSDALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1931 WEST A ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101
Mailing Address - Country:US
Mailing Address - Phone:308-532-4700
Mailing Address - Fax:308-534-0534
Practice Address - Street 1:1931 WEST A ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101
Practice Address - Country:US
Practice Address - Phone:308-532-4700
Practice Address - Fax:308-534-0534
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15625207ND0900X, 207NS0135X, 2083P0901X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEE37939Medicare UPIN
NE088480Medicare ID - Type Unspecified