Individual
MARY G. BARRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
825 BARRET AVE, LOUISVILLE, KY 40204-1743
(502) 540-7200
(502) 540-7207
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 272-5100
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25092
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000050959
ANTHEM / NCMA
KY
01
—
000026447D
HUMANA / NCMA
KY
01
—
008914
SIHO / NCMA
KY
05
—
100360820
—
IN
01
—
1054765
PASSPORT / NCMA
KY
01
—
110139124
RAILROAD MEDICARE
KY
01
—
2433720000
PASSPORT ADVANTAGE / NCMA
KY
05
—
64250921
—
KY
Enumeration date
04/18/2006
Last updated
09/28/2020
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