Provider Demographics
NPI:1497884191
Name:BARR, JOHN T (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:BARR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2567 HOUSLEY RD
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-6751
Mailing Address - Country:US
Mailing Address - Phone:410-224-2306
Mailing Address - Fax:410-224-0206
Practice Address - Street 1:2567 HOUSLEY RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-6751
Practice Address - Country:US
Practice Address - Phone:410-224-2306
Practice Address - Fax:410-224-0206
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA-1003152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD622M 112FMedicare ID - Type UnspecifiedINDIVIDUAL MEDICARE
MDU16798Medicare UPIN