Provider Demographics
NPI:1972610293
Name:BARBER, CHESTER LEE JR (PD)
Entity Type:Individual
Prefix:MR
First Name:CHESTER
Middle Name:LEE
Last Name:BARBER
Suffix:JR
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1357 W COLLIN RAYE DR
Mailing Address - Street 2:
Mailing Address - City:DE QUEEN
Mailing Address - State:AR
Mailing Address - Zip Code:71832-2946
Mailing Address - Country:US
Mailing Address - Phone:870-642-2400
Mailing Address - Fax:870-642-5526
Practice Address - Street 1:1357 W COLLIN RAYE DR
Practice Address - Street 2:
Practice Address - City:DE QUEEN
Practice Address - State:AR
Practice Address - Zip Code:71832-2946
Practice Address - Country:US
Practice Address - Phone:870-642-2400
Practice Address - Fax:870-642-5526
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARPD07169183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR164404716Medicaid
AR155535407Medicaid
0421026OtherNCPDP NUMBER
OK200018110AMedicaid
AR4269800001Medicare NSC