Provider Demographics
NPI:1588627061
Name:BARR, DANIEL ROSS (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ROSS
Last Name:BARR
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 1:62 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-3508
Mailing Address - Country:US
Mailing Address - Phone:507-454-4523
Mailing Address - Fax:507-454-0116
Practice Address - Street 1:62 E 4TH ST
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-3508
Practice Address - Country:US
Practice Address - Phone:507-454-4523
Practice Address - Fax:507-454-0116
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN25602173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN30371500Medicaid
MND83728Medicare UPIN