Timothy D Barry, M.D.

Individual provider Active NPI Obstetrics & Gynecology Physician · Walla Walla, WA

NPI 1093789778 · NPPES record last updated Nov 27, 2007

Key facts

NPI
1093789778
Entity type
Individual (NPI type 1)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
License
MD00018194 (WA)
Practice address
320 Willow
Walla Walla, WA 99362
Phone
(509) 525-5010
Fax
(509) 522-9448
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00018194WAMDObstetrics & Gynecology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD00018194 WA Yes

Addresses

Primary practice location

320 Willow
Walla Walla, WA 99362

Mailing address

55 W Tietan St
Walla Walla, WA 99362-4445
Phone (509) 525-3720

Other identifiers

IdentifierTypeStateIssuer
8489106MedicaidWA
066894MedicaidOR
30248OtherWAL&I

Other providers in Walla Walla, WA

All providers in Walla Walla, WA · Obstetrics & Gynecology Physician in Washington

Sources for this page

Verify at the official NPI Registry.