Provider Demographics
NPI:1669562153
Name:BARBER, LAURIE (MD)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:BARBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 EXECUTIVE CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-4536
Mailing Address - Country:US
Mailing Address - Phone:501-224-5658
Mailing Address - Fax:
Practice Address - Street 1:4104 RICHARDS RD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2652
Practice Address - Country:US
Practice Address - Phone:501-224-5658
Practice Address - Fax:501-224-8114
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR-3568207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR063764000OtherRAILROAD MEDICARE
AR117557001Medicaid
ARP00020671OtherRAILROAD MEDICARE
53712Medicare PIN
E91734Medicare UPIN