Provider Demographics
NPI:1215054127
Name:PHILLIPS, BARRY DAVID (OD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:DAVID
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 SE 29TH TER
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4715
Mailing Address - Country:US
Mailing Address - Phone:352-351-2728
Mailing Address - Fax:352-351-2728
Practice Address - Street 1:3100 SW COLLEGE RD
Practice Address - Street 2:INSIDE SEARS OPTICAL
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7446
Practice Address - Country:US
Practice Address - Phone:352-291-2020
Practice Address - Fax:352-873-9110
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 2302152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU42960Medicare UPIN