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Provider Information for 1679511802

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

J DAVID BARR PAC

Other Name:   JOHN BARR
Gender: MALE

Individual NPI: 1679511802

Calendar   Last Updated:  2018-09-04
  Certification Date: 

Details

Name Value
NPI 1679511802
Enumeration Date 2006-06-02
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 18865 STATE ROAD 54 # 301
LUTZ, FL 33558-8201
United States

Phone: 813-459-7711 | Fax: 813-235-4175
View Map External Link
Primary Practice Address 16734 IVY LAKE DR
ODESSA, FL 33556-6020
United States

Phone: 813-459-7711 | Fax: 813-235-4175
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 363A00000X - Physician Assistant ZZ PA9108698