Provider Demographics
NPI:1548220775
Name:BARCOMB, ALAN JAMES (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:JAMES
Last Name:BARCOMB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OAKFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14125-1014
Mailing Address - Country:US
Mailing Address - Phone:585-948-8077
Mailing Address - Fax:585-948-9159
Practice Address - Street 1:41 MAIN ST
Practice Address - Street 2:
Practice Address - City:OAKFIELD
Practice Address - State:NY
Practice Address - Zip Code:14125-1014
Practice Address - Country:US
Practice Address - Phone:585-948-8077
Practice Address - Fax:585-948-9159
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY180011207QA0401X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYUNIVERAOther00010197301
NYBB0564OtherMEDICARE ID
NY01638595Medicaid
NY990008205OtherMEDICARE RAILROAD
NYP010180011OtherBLUE CHOICE
NY000523719002OtherBCBS WNY
NYMDC198OtherPREFERRED CARE
NY0109523OtherINDEPENDENT HEALTH
NY0591OtherBCBS ROCHESTER
NYMDC198OtherPREFERRED CARE
NYBB0564OtherMEDICARE ID