=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497884191
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN T. BARR O.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/06/2007
-----------------------------------------------------
Last Update Date | 07/09/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2567 HOUSLEY RD
-----------------------------------------------------
City | ANNAPOLIS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21401-6751
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-224-2306
-----------------------------------------------------
Fax | 410-224-0206
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2567 HOUSLEY RD
-----------------------------------------------------
City | ANNAPOLIS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21401-6751
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-224-2306
-----------------------------------------------------
Fax | 410-224-0206
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | TA-1003
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------