Healthcare Provider Details

I. General information

NPI: 1558358440
Provider Name (Legal Business Name): WILLIAM A BARRY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 11/10/2020
Certification Date: 11/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 DUFF AVE
AMES IA
50010-5793
US

IV. Provider business mailing address

1111 DUFF AVE
AMES IA
50010-5793
US

V. Phone/Fax

Practice location:
  • Phone: 515-239-6992
  • Fax: 515-239-3642
Mailing address:
  • Phone: 515-239-6992
  • Fax: 515-239-3642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number33407
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: