Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 36002631 | OH |
NPI | 1093710147 |
---|---|
Provider Name | Dr. Gregory Lee Barbour |
First Address | Dayton, OH 45459-4778 |
Second Address | Dayton, OH 45459-4778 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 29/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2124712 | (05) | OH |
U13478 | (02) | OH |