Provider Demographics
NPI:1922430792
Name:BARRY L HARRIS, OD, PA
Entity Type:Organization
Organization Name:BARRY L HARRIS, OD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:E
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:870-623-0967
Mailing Address - Street 1:901 LINWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-4854
Mailing Address - Country:US
Mailing Address - Phone:870-239-2251
Mailing Address - Fax:
Practice Address - Street 1:901 LINWOOD DR
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-4854
Practice Address - Country:US
Practice Address - Phone:870-239-2251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-05
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
496207933OtherMEDICARE
AR102580722Medicaid
ARP00146489OtherRAILROAD MEDICARE
AR102580722Medicaid
496207933OtherMEDICARE