Provider Demographics
NPI:1205950565
Name:BARRY, WOODROW P (PA)
Entity type:Individual
Prefix:
First Name:WOODROW
Middle Name:P
Last Name:BARRY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1069 DELAWARE AVE
Mailing Address - Street 2:STE. 205
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-1400
Mailing Address - Country:US
Mailing Address - Phone:740-223-3496
Mailing Address - Fax:740-382-6463
Practice Address - Street 1:1069 DELAWARE AVE
Practice Address - Street 2:STE. 205
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-1400
Practice Address - Country:US
Practice Address - Phone:740-223-3496
Practice Address - Fax:740-382-6463
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50-00-0440363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant