Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 4497 | KY |
NPI | 1003997974 |
---|---|
Provider Name | Dr. James Robert Barrett |
First Address | Benton, KY 42025-7464 |
Second Address | Benton, KY 42025-7464 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 05/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
85001105 | (05) | KY |
U82350 | (02) | KY |