Provider Demographics
NPI:1437142635
Name:BARTH, LINDSAY D (DPM)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:D
Last Name:BARTH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 78157
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63178-8157
Mailing Address - Country:US
Mailing Address - Phone:314-909-1920
Mailing Address - Fax:314-909-1980
Practice Address - Street 1:5139 MATTIS RD STE 102
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2250
Practice Address - Country:US
Practice Address - Phone:314-909-1920
Practice Address - Fax:314-909-1980
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016004794213ES0103X
MO000724213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO308531805Medicaid
ILK14241Medicare PIN
MO213491359Medicare PIN
MO308531805Medicaid