Provider Demographics
NPI:1144213521
Name:BARGER, LAWRENCE J (OD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:J
Last Name:BARGER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 SPRINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2468
Mailing Address - Country:US
Mailing Address - Phone:330-666-0707
Mailing Address - Fax:330-668-4884
Practice Address - Street 1:150 SPRINGSIDE DR
Practice Address - Street 2:C330
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-2468
Practice Address - Country:US
Practice Address - Phone:330-666-0707
Practice Address - Fax:330-668-4884
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2880/T344152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0225414Medicaid
OHT80820Medicare UPIN
OH0225414Medicaid