Provider Demographics
NPI:1245315266
Name:WILLIAM H BARSTOW MD
Entity type:Organization
Organization Name:WILLIAM H BARSTOW MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:BARSTOW
Authorized Official - Suffix:IV
Authorized Official - Credentials:MD
Authorized Official - Phone:541-526-6635
Mailing Address - Street 1:213 NW LARCH AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-1323
Mailing Address - Country:US
Mailing Address - Phone:541-526-6635
Mailing Address - Fax:541-526-6636
Practice Address - Street 1:213 NW LARCH AVE
Practice Address - Street 2:SUITE A
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-1323
Practice Address - Country:US
Practice Address - Phone:541-526-6635
Practice Address - Fax:541-526-6636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD21764207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR130895Medicare ID - Type Unspecified
F72057Medicare UPIN