Provider Demographics
NPI:1942463039
Name:BARBER, LAURA JO (DPH)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:JO
Last Name:BARBER
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5217
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37864-5217
Mailing Address - Country:US
Mailing Address - Phone:865-428-7439
Mailing Address - Fax:865-453-4515
Practice Address - Street 1:2453 BOYDS CREEK
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37876
Practice Address - Country:US
Practice Address - Phone:865-428-7439
Practice Address - Fax:865-453-4515
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4628183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist