Provider Demographics
NPI:1316009731
Name:URETSKY, BARRY F (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:F
Last Name:URETSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 W MARKHAM ST
Mailing Address - Street 2:S-304 SHOREY BUILDING
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:501-688-9417
Mailing Address - Fax:501-257-5796
Practice Address - Street 1:4301 MARHAM AVENUE
Practice Address - Street 2:S-304 SHOREY BUILDING
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-603-1267
Practice Address - Fax:501-257-5796
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1155207RC0000X
ARE5214207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR164042001Medicaid
TX118811201Medicaid
OK200103240AMedicaid
AR5N790Medicare ID - Type Unspecified
AR164042001Medicaid
TX118811201Medicaid
OK200103240AMedicaid