Provider Demographics
NPI:1073700969
Name:BARBER, SAMUEL RALPH (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:RALPH
Last Name:BARBER
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 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-765-7735
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:7777 HENNESSY BLVD STE 709
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4366
Practice Address - Country:US
Practice Address - Phone:225-765-7735
Practice Address - Fax:225-765-9937
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2022-10-05
Deactivation Date:2020-06-30
Deactivation Code:
Reactivation Date:2021-01-13
Provider Licenses
StateLicense IDTaxonomies
AZR76064207Y00000X
LA331171207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA331171OtherSTATE LICENSE