Provider Demographics
NPI:1295836575
Name:BARRETT, WILLIAM LAURENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LAURENCE
Last Name:BARRETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2555 COURT DR
Mailing Address - Street 2:SUITE 450
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2134
Mailing Address - Country:US
Mailing Address - Phone:704-671-7652
Mailing Address - Fax:704-671-7656
Practice Address - Street 1:2555 COURT DR
Practice Address - Street 2:SUITE 450
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2134
Practice Address - Country:US
Practice Address - Phone:704-671-7652
Practice Address - Fax:704-671-7656
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK23280208600000X
NC2001-00507208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200022730AMedicaid
OK200022730AMedicaid
OKH58759Medicare UPIN