Provider Demographics
NPI:1235111550
Name:BARRY, YVONNE A (MD, PHD)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:A
Last Name:BARRY
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8379 W SUNSET RD STE 210
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2243
Mailing Address - Country:US
Mailing Address - Phone:725-200-3232
Mailing Address - Fax:725-220-6389
Practice Address - Street 1:5915 S RAINBOW BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-2558
Practice Address - Country:US
Practice Address - Phone:702-666-8808
Practice Address - Fax:702-362-9954
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019787Medicaid
NVG17352Medicare UPIN
101943Medicare PIN