Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 5101012426 | MI |
NPI | 1235102260 |
---|---|
Provider Name | Dr. Neysa L Bartlett |
First Address | Marshall, MI 49068-1559 |
Second Address | Marshall, MI 49068-1559 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2006 |
Last Update Date | 01/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4390871 | (05) | MI |
5130061 | BCBS (01) | MI |
5791690 | AETNA (01) | MI |
F37116 | (02) | MI |
P95391 | BLUE CHOICE & BCN (01) | MI |