Provider Demographics
NPI:1386728079
Name:BARBER, LAURA A
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:A
Last Name:BARBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 318
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05033-0318
Mailing Address - Country:US
Mailing Address - Phone:802-222-9317
Mailing Address - Fax:888-462-0883
Practice Address - Street 1:437 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:VT
Practice Address - Zip Code:05033-9196
Practice Address - Country:US
Practice Address - Phone:802-222-9317
Practice Address - Fax:888-462-0883
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5641207Q00000X
VT042.0013167207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB26647Medicare UPIN