Provider Demographics
NPI:1538153952
Name:COUCH, JOANN BARBOUR (MD)
Entity type:Individual
Prefix:
First Name:JOANN
Middle Name:BARBOUR
Last Name:COUCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOANN
Other - Middle Name:
Other - Last Name:BARBOUR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2402 W PIERCE ST STE 5A
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-3567
Mailing Address - Country:US
Mailing Address - Phone:575-887-7337
Mailing Address - Fax:575-887-5377
Practice Address - Street 1:2402 W PIERCE ST STE 5A
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-3567
Practice Address - Country:US
Practice Address - Phone:575-887-7337
Practice Address - Fax:575-887-5377
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO118123208000000X
MO118113208000000X
NMMD2020-0644208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics