Provider Demographics
NPI:1619983806
Name:STEIN, BARRY JAY (O D)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:JAY
Last Name:STEIN
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6601 N DAVIS HWY STE 1-B
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-6210
Mailing Address - Country:US
Mailing Address - Phone:850-476-6100
Mailing Address - Fax:850-471-1155
Practice Address - Street 1:6601 N DAVIS HWY STE 1-B
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-6210
Practice Address - Country:US
Practice Address - Phone:850-476-6100
Practice Address - Fax:850-471-1155
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 2125152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL620681600Medicaid
FL620681600Medicaid
FLU27084Medicare UPIN