Provider Demographics
NPI:1689912651
Name:BARRY, WILLIAM EARL (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EARL
Last Name:BARRY
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 1:100 POST OAK TRL
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-1300
Mailing Address - Country:US
Mailing Address - Phone:705-353-0454
Mailing Address - Fax:706-353-8411
Practice Address - Street 1:100 POST OAK TRL
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-1300
Practice Address - Country:US
Practice Address - Phone:705-353-0454
Practice Address - Fax:706-353-8411
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA12422207N00000X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology