Provider Demographics
NPI:1700842606
Name:GARY D BARHAM MD PA
Entity Type:Organization
Organization Name:GARY D BARHAM MD PA
Other - Org Name:HILLRISE ORTHOPAEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PA PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BARHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-521-9729
Mailing Address - Street 1:2911 HILLRISE DR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011
Mailing Address - Country:US
Mailing Address - Phone:505-521-9729
Mailing Address - Fax:505-522-4166
Practice Address - Street 1:2911 HILLRISE DR
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011
Practice Address - Country:US
Practice Address - Phone:505-521-9729
Practice Address - Fax:505-522-4166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty