Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 415 | LA |
NPI | 1164421830 |
---|---|
Provider Name | Dr. John S Barrett |
First Address | Metairie, LA 70002-1469 |
Second Address | La Place, LA 70068-3816 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1941409 | (05) | LA |
2270A | BLUE CROSS BLUE SHIELD (01) | LA |
4394099 | AETNA (01) | LA |
T19938 | (02) | LA |