Provider Demographics
NPI:1417387648
Name:PRIMARILY GERIATRICS, LLC
Entity Type:Organization
Organization Name:PRIMARILY GERIATRICS, LLC
Other - Org Name:RUSSELL T. BARR, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:BARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-260-9535
Mailing Address - Street 1:1501 7TH ST SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-3378
Mailing Address - Country:US
Mailing Address - Phone:256-355-5315
Mailing Address - Fax:
Practice Address - Street 1:1501 7TH ST SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3378
Practice Address - Country:US
Practice Address - Phone:256-355-5315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-25
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12034261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC73029Medicare UPIN