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General NPI Number Information
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NPI Number | 1407904303
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Entity Type | Individual
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Provider Name | BARRY H. STANDLEY MD
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Gender | Male
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 09/01/2013
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Provider Practice Location Address
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Address Line | 5012 SEVILLA AVE NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-1832
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Country | US
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Telephone | 505-839-3860
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Fax |
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Provider Business Mailing Address
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Address Line | 5012 SEVILLA AVE NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-1832
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Country | US
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Telephone | 505-839-3860
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | C42541
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 82-132
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License Number State | NM
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