Provider Demographics
NPI:1609828961
Name:BARGA, ANDREW PAUL (PA)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:PAUL
Last Name:BARGA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 E. HIGH STREET
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505
Mailing Address - Country:US
Mailing Address - Phone:937-328-8700
Mailing Address - Fax:937-328-8719
Practice Address - Street 1:2501 E. HIGH STREET
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505
Practice Address - Country:US
Practice Address - Phone:937-328-8700
Practice Address - Fax:937-328-8719
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50000697363A00000X
OH50.000697363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00054527OtherRAIL ROAD MEDICARE
P00054527OtherRAIL ROAD MEDICARE
S57827Medicare UPIN