Healthcare Provider Details

I. General information

NPI: 1447286133
Provider Name (Legal Business Name): MARILYN I BARR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 HUNTINGTON AVE
MANSFIELD AR
72944-3741
US

IV. Provider business mailing address

PO BOX 17000
FORT SMITH AR
72917-7000
US

V. Phone/Fax

Practice location:
  • Phone: 479-314-1131
  • Fax: 479-314-1194
Mailing address:
  • Phone: 479-314-1131
  • Fax: 479-314-1194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC5810
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: