Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | ME103823 | FL |
NPI | 1003140963 |
---|---|
Provider Name | Dr. Leslie Erin Barr |
First Address | West Plains, MO 65775-2022 |
Second Address | West Plains, MO 65775-2022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2009 |
Last Update Date | 29/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003140963 | (05) | MO |
2009039074 | MISSOURI MEDICAL LICENSE (01) | MO |
ME103823 | FLORIDA MEDICAL LICENSE (01) | FL |