Provider Demographics
NPI:1750350427
Name:BARRY, ROBIN J (MD)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:J
Last Name:BARRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4212 W CONGRESS ST STE 1500
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-6767
Mailing Address - Country:US
Mailing Address - Phone:337-981-6464
Mailing Address - Fax:337-981-6440
Practice Address - Street 1:4212 W CONGRESS ST
Practice Address - Street 2:SUITE 1500
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-6765
Practice Address - Country:US
Practice Address - Phone:337-981-6464
Practice Address - Fax:337-981-6440
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2025-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA014705207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1315842Medicaid
B61684Medicare UPIN
5M169F652Medicare PIN