Provider Demographics
NPI:1326145038
Name:SOBEL, BARRY J (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:J
Last Name:SOBEL
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 1:2635 N 7TH ST
Mailing Address - Street 2:SMG NEPHROLOGY
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-8209
Mailing Address - Country:US
Mailing Address - Phone:970-298-2273
Mailing Address - Fax:
Practice Address - Street 1:2635 NORTH 7TH. STREET
Practice Address - Street 2:4 CENTER
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501
Practice Address - Country:US
Practice Address - Phone:970-298-7106
Practice Address - Fax:970-298-7177
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0049789207RN0300X
KY38486207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO86981234Medicaid
KY64063456Medicaid
000000308960OtherBCBS PROVIDER NUMBER
KY38486OtherLICENSE
KY38486OtherLICENSE
KYP00126357Medicare PIN
000000308960OtherBCBS PROVIDER NUMBER
A91640Medicare UPIN
KY00503033Medicare PIN
CO350933ZAC1Medicare PIN