Provider Demographics
NPI:1447286133
Name:BARR, MARILYN I (MD)
Entity type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:I
Last Name:BARR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17000
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72917-7000
Mailing Address - Country:US
Mailing Address - Phone:479-314-1131
Mailing Address - Fax:479-314-1194
Practice Address - Street 1:103 HUNTINGTON AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:AR
Practice Address - Zip Code:72944-3741
Practice Address - Country:US
Practice Address - Phone:479-314-1131
Practice Address - Fax:479-314-1194
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC5810207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR50326Medicare ID - Type Unspecified
D04340Medicare UPIN