Provider Demographics
NPI:1265664098
Name:BARR, JOSHUA A (IDMT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:A
Last Name:BARR
Suffix:
Gender:M
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 LEMAY PLZ N
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36112-6025
Mailing Address - Country:US
Mailing Address - Phone:334-953-6256
Mailing Address - Fax:
Practice Address - Street 1:501 LEMAY PLZ N
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36112-6025
Practice Address - Country:US
Practice Address - Phone:334-953-6256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians