Provider Demographics
NPI:1588879811
Name:WEEKS, BARRY L (DMD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:L
Last Name:WEEKS
Suffix:
Gender:M
Credentials:DMD
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 806
Mailing Address - Street 2:
Mailing Address - City:WATER VALLEY
Mailing Address - State:MS
Mailing Address - Zip Code:38965-0806
Mailing Address - Country:US
Mailing Address - Phone:662-473-1133
Mailing Address - Fax:662-473-9146
Practice Address - Street 1:605 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WATER VALLEY
Practice Address - State:MS
Practice Address - Zip Code:38965-2525
Practice Address - Country:US
Practice Address - Phone:662-473-1133
Practice Address - Fax:662-473-9146
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2037-831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice