Provider Demographics
NPI:1790713956
Name:BARBER, DAVID WILLIAM (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WILLIAM
Last Name:BARBER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10430 MOREHEAD DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-4228
Mailing Address - Country:US
Mailing Address - Phone:804-721-9623
Mailing Address - Fax:804-706-9468
Practice Address - Street 1:10430 MOREHEAD DR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-4228
Practice Address - Country:US
Practice Address - Phone:804-721-9623
Practice Address - Fax:804-706-9468
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0168000151152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009236121Medicaid
VA410000606Medicare ID - Type Unspecified
VA009236121Medicaid