MEDICARE: DR. BYRON L. BARKSDALE M.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	207ND0900X	Dermatopathology Physician	15625	NE
2	207NS0135X	Procedural Dermatology Physician	15625	NE
3	2083P0901X	Public Health & General Preventive Medicine Physician	15625	NE
4	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	15625	NE

General Provider Information

NPI Number	:	1073508750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BYRON L. BARKSDALE M.D.

Provider Business Mailing Address
First Line	:	1931 WEST A ST
Second Line	:
City	:	NORTH PLATTE
State	:	NE
Zip	:	69101
Country	:	US
Telephone Number	:	308-532-4700
Fax Number	:	308-534-0534

Provider Business Practice Location Address
First Line	:	1931 WEST A ST
Second Line	:
City	:	NORTH PLATTE
State	:	NE
Zip	:	69101
Country	:	US
Telephone Number	:	308-532-4700
Fax Number	:	308-534-0534

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

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	04/14/2023

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