Provider Demographics
NPI:1609842376
Name:LAMKIN, BARRY CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:CHARLES
Last Name:LAMKIN
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 1:3624 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-4510
Mailing Address - Country:US
Mailing Address - Phone:330-665-0555
Mailing Address - Fax:330-665-0556
Practice Address - Street 1:3624 W MARKET ST
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-4510
Practice Address - Country:US
Practice Address - Phone:330-665-0555
Practice Address - Fax:330-665-0556
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-6415-L207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0474795Medicaid
OH9186054OtherMEDICARE GROUP LEGACY NUM
OH9186055OtherMEDICARE GROUP LEGACY NUM
OHP00041619OtherRAILROAD MEDICARE NUMBER
OH1154487932OtherGROUP NPI NUMBER
OH1154487932OtherGROUP NPI NUMBER
OH0474795Medicaid
OHLA0501755Medicare PIN