1801812938 NPI number — DR. GREGORY P. BARCLAY M.D.

Table of content: DR. GREGORY P. BARCLAY M.D. (NPI 1801812938)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801812938 NPI number — DR. GREGORY P. BARCLAY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARCLAY
Provider First Name:
GREGORY
Provider Middle Name:
P.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801812938
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/16/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1525 AIRPORT RD
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
AMES
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50010-8231
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-292-3023
Provider Business Mailing Address Fax Number:
515-292-3053

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1525 AIRPORT RD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
AMES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50010-8231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-292-3023
Provider Business Practice Location Address Fax Number:
515-292-3053
Provider Enumeration Date:
07/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  31216 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: IP308999 . This is a "MBC OF IOWA" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 27051 . This is a "HAWK-I" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 43478 . This is a "WELLMARK BCBS" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 072702 . This is a "HEALTH ALLIANCE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 1137018 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 49646 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 71792 . This is a "APS" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 7659418 . This is a "AETNA" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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