Provider Demographics
NPI:1538218979
Name:BARR, JOHN F (MD, COF)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:BARR
Suffix:
Gender:M
Credentials:MD, COF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 FOUR SEASONS WAY
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6080
Mailing Address - Country:US
Mailing Address - Phone:704-798-3175
Mailing Address - Fax:
Practice Address - Street 1:132 FOUR SEASONS WAY
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-6080
Practice Address - Country:US
Practice Address - Phone:704-798-3175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2023-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26186207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1538218979OtherBCBS
NC1669509857OtherBCBS OF NC
NC89134N6Medicaid
NC1538218979OtherCHAMPUS/TRICARE
NC1669509857OtherBCBS OF NC
NC1538218979OtherCHAMPUS/TRICARE