Basic Information
Provider Information
NPI: 1003803867
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ANDERSON
FirstName: BARRIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 HAWKINS DR
Address2: UNIVERSITY OF IOWA HOSPITALS & CLINICS
City: IOWA CITY
State: IA
PostalCode: 522421009
CountryCode: US
TelephoneNumber: 3193562015
FaxNumber: 3193538363
Practice Location
Address1: 200 HAWKINS DR
Address2: UNIVERSITY OF IOWA HOSPITALS & CLINICS
City: IOWA CITY
State: IA
PostalCode: 522421009
CountryCode: US
TelephoneNumber: 3193562015
FaxNumber: 3193538363
Other Information
ProviderEnumerationDate: 10/05/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X22877IAX Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207VX0201X22877IAX Allopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology

ID Information
IDTypeStateIssuerDescription
019091805IA MEDICAID
1909101IAWELLMARK BCBSOTHER


Home