Provider Demographics
NPI:1083670095
Name:PIERCE, BARRY D (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:D
Last Name:PIERCE
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 1:2106 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:AR
Mailing Address - Zip Code:72560-0510
Mailing Address - Country:US
Mailing Address - Phone:870-262-5056
Mailing Address - Fax:870-269-3093
Practice Address - Street 1:2106 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:AR
Practice Address - Zip Code:72560-0510
Practice Address - Country:US
Practice Address - Phone:870-262-5056
Practice Address - Fax:870-269-3093
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE3494207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR148557001Medicaid
AR5M369Medicare ID - Type Unspecified
AR148557001Medicaid