Provider Demographics
NPI:1073515151
Name:FARBER, BARRY S (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:S
Last Name:FARBER
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 1:3850 S NATIONAL AVE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5287
Mailing Address - Country:US
Mailing Address - Phone:417-269-6944
Mailing Address - Fax:417-269-6947
Practice Address - Street 1:3850 S NATIONAL AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5287
Practice Address - Country:US
Practice Address - Phone:417-269-6944
Practice Address - Fax:417-269-6947
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6130208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200346625Medicaid
MOR6130OtherSTATE LICENSE