Provider Demographics
NPI:1538363247
Name:BARKSDALE, ANDREW R (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:R
Last Name:BARKSDALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5255 EAST STOP 11 RD.
Mailing Address - Street 2:#200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237
Mailing Address - Country:US
Mailing Address - Phone:317-851-2331
Mailing Address - Fax:317-851-2333
Practice Address - Street 1:5255 EAST STOP 11 RD.
Practice Address - Street 2:#200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237
Practice Address - Country:US
Practice Address - Phone:317-851-2331
Practice Address - Fax:317-851-2333
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2021-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036118201208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN877470RMedicare PIN
ILK44706Medicare PIN
IL202172002Medicare PIN
ILH38942Medicare UPIN
ILK44705Medicare PIN