Provider Demographics
NPI:1992704969
Name:BARBER, GERALD MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:MICHAEL
Last Name:BARBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12525 PERKINS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-1907
Mailing Address - Country:US
Mailing Address - Phone:225-765-4256
Mailing Address - Fax:225-765-4034
Practice Address - Street 1:12525 PERKINS RD
Practice Address - Street 2:SUITE A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-1907
Practice Address - Country:US
Practice Address - Phone:225-765-4256
Practice Address - Fax:225-765-4034
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017635207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1352977Medicaid
LA080130383OtherRAILROAD MEDICARE
LA1352977Medicaid
LA53331D279Medicare PIN