Provider Demographics
NPI:1669715546
Name:BARRY, NEIL GORDON IV (DO, MBA)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:GORDON
Last Name:BARRY
Suffix:IV
Gender:M
Credentials:DO, MBA
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Mailing Address - Street 1:10800 PARKSIDE DR STE 331
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-1922
Mailing Address - Country:US
Mailing Address - Phone:865-392-3400
Mailing Address - Fax:865-392-3449
Practice Address - Street 1:10800 PARKSIDE DR STE 331
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1922
Practice Address - Country:US
Practice Address - Phone:865-392-3400
Practice Address - Fax:865-392-3449
Is Sole Proprietor?:No
Enumeration Date:2013-03-29
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNDO2756207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease