Provider Demographics
NPI:1275718991
Name:BARRY J LA CLAIR MD PA
Entity Type:Organization
Organization Name:BARRY J LA CLAIR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:LACLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-349-6161
Mailing Address - Street 1:121 AVENIDA MESSINA
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34242
Mailing Address - Country:US
Mailing Address - Phone:941-349-6161
Mailing Address - Fax:941-349-5111
Practice Address - Street 1:121 AVENIDA MESSINA
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34242
Practice Address - Country:US
Practice Address - Phone:941-349-6161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2702Medicare PIN