Provider Demographics
NPI:1518295583
Name:BARRY J SOBEL MD LLC
Entity Type:Organization
Organization Name:BARRY J SOBEL MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:SOBEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-216-5807
Mailing Address - Street 1:441 MEDITERRANEAN WAY
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81507
Mailing Address - Country:US
Mailing Address - Phone:970-424-0318
Mailing Address - Fax:270-825-0766
Practice Address - Street 1:1015 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-9189
Practice Address - Country:US
Practice Address - Phone:270-825-1328
Practice Address - Fax:270-825-0766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-02
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY01221Medicare PIN