MEDICARE: PATRICK J BARRY O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	013AZ	AZ

General Provider Information

NPI Number	:	1487650263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK J BARRY O.D.

Provider Business Mailing Address
First Line	:	525 W WETMORE RD
Second Line	:	SUITE #101
City	:	TUCSON
State	:	AZ
Zip	:	85705-5094
Country	:	US
Telephone Number	:	520-293-2363
Fax Number	:	520-293-0475

Provider Business Practice Location Address
First Line	:	525 W WETMORE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85705-5094
Country	:	US
Telephone Number	:	520-293-2363
Fax Number	:	520-293-0475

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	12/13/2007

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