Provider Demographics
NPI:1730195801
Name:BARTH, ROGER A (MD)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:A
Last Name:BARTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:175 TIMBERWOLF PKWY
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-1218
Mailing Address - Country:US
Mailing Address - Phone:406-257-2020
Mailing Address - Fax:406-257-5554
Practice Address - Street 1:175 TIMBERWOLF PKWY
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-1218
Practice Address - Country:US
Practice Address - Phone:406-257-2020
Practice Address - Fax:406-257-5554
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT6824207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT89349Medicaid
MT89349Medicaid
MTE48726Medicare UPIN