Provider Demographics
NPI:1134125297
Name:BARGER, DENVER LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:DENVER
Middle Name:LEE
Last Name:BARGER
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:PO BOX 1265
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-1265
Mailing Address - Country:US
Mailing Address - Phone:501-843-5757
Mailing Address - Fax:501-843-5700
Practice Address - Street 1:1911 N 2ND ST
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-2209
Practice Address - Country:US
Practice Address - Phone:501-843-5757
Practice Address - Fax:501-843-5700
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC6568207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARC67785Medicare UPIN
AR50269Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE ID#