Provider Demographics
NPI:1114196391
Name:BARBARA L ATWOOD MD LLC
Entity Type:Organization
Organization Name:BARBARA L ATWOOD MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ATWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-946-0802
Mailing Address - Street 1:953 STEVENS DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-3533
Mailing Address - Country:US
Mailing Address - Phone:509-946-0802
Mailing Address - Fax:509-946-0104
Practice Address - Street 1:953 STEVENS DR
Practice Address - Street 2:SUITE B
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3533
Practice Address - Country:US
Practice Address - Phone:509-946-0802
Practice Address - Fax:509-946-0104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602397859207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1122936Medicaid
WA8803639Medicare PIN
WA1122936Medicaid