Provider Demographics
NPI:1295751352
Name:RIVES, BARRY JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:JAMES
Last Name:RIVES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8285 W ARBY AVE STE 190
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2238
Mailing Address - Country:US
Mailing Address - Phone:702-263-9644
Mailing Address - Fax:702-270-4062
Practice Address - Street 1:8285 W ARBY AVE STE 190
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-2238
Practice Address - Country:US
Practice Address - Phone:702-263-9644
Practice Address - Fax:702-270-4062
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10642208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV104749Medicare PIN