Provider Demographics
NPI:1154466829
Name:BARBER, JACK W (MD)
Entity Type:Individual
Prefix:
First Name:JACK
Middle Name:W
Last Name:BARBER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:500 RAY C HUNT DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-2981
Mailing Address - Country:US
Mailing Address - Phone:434-980-6140
Mailing Address - Fax:434-972-4266
Practice Address - Street 1:UVA PRIMARY CARE CTR
Practice Address - Street 2:LEE STREET, 4TH FLOOR
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0001
Practice Address - Country:US
Practice Address - Phone:434-243-4646
Practice Address - Fax:434-243-4260
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01010380982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD26932Medicare UPIN