# BARRY A MATHISON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1396816922
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 1038539A | IN | Yes |
| 208M00000X | Hospitalist Physician | 01038539A | IN | — |

## Other

- **Enumeration date:** 11/13/2006
- **Last updated:** 08/02/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000207927 | ANTHEM ID\# | IN |
| 05 | — | 100196520 | — | IN |