Basic Information
Provider Information
NPI: 1962524090
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ELLINGTON
FirstName: BARBARA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 23070
Address2:  
City: BARLING
State: AR
PostalCode: 729230070
CountryCode: US
TelephoneNumber: 4794525040
FaxNumber: 4794525047
Practice Location
Address1: 1340 S WALDRON RD
Address2:  
City: FORT SMITH
State: AR
PostalCode: 729032556
CountryCode: US
TelephoneNumber: 4794525040
FaxNumber: 4794525047
Other Information
ProviderEnumerationDate: 04/06/2007
LastUpdateDate: 11/09/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XC7468ARY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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