Basic Information
| Provider Information | |||||||||
| NPI: | 1871667618 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARBE | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | O. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 120 W 16TH ST | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN GROVE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 657111039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4179266111 | ||||||||
| FaxNumber: | 4178294316 | ||||||||
| Practice Location | |||||||||
| Address1: | 120 W 16TH ST | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN GROVE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 657111039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4179266111 | ||||||||
| FaxNumber: | 4178294316 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2006 | ||||||||
| LastUpdateDate: | 09/27/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | R9C21 | MO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 201861101 | 05 | MO | MEDICAID |