Provider Demographics
NPI:1376099689
Name:BARR, VICTOR WOOD
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:WOOD
Last Name:BARR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 GRENADA BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-6316
Mailing Address - Country:US
Mailing Address - Phone:865-368-8609
Mailing Address - Fax:
Practice Address - Street 1:1904 GRENADA BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-6316
Practice Address - Country:US
Practice Address - Phone:865-368-8609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-27
Last Update Date:2016-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1862103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist