Provider Demographics
NPI:1457312027
Name:BARR, JASON ARTHUR (DO)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:ARTHUR
Last Name:BARR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20401 N 73RD STREET
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-4153
Mailing Address - Country:US
Mailing Address - Phone:480-556-0446
Mailing Address - Fax:480-556-0447
Practice Address - Street 1:20401 N 73RD STREET
Practice Address - Street 2:SUITE 230
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4153
Practice Address - Country:US
Practice Address - Phone:480-556-0446
Practice Address - Fax:480-556-0447
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3866207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ403814Medicaid
AZ74-3037351OtherTAX ID
AZ403814Medicaid
AZZ78378Medicare UPIN