Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 13840 | RI |
N | 207X00000X | Orthopaedic Surgeon | LP01073 | RI |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 070339 | GA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | P5595 | TX |
NPI | 1740482850 |
---|---|
Provider Name | Jason Tyler Bariteau |
First Address | Atlanta, GA 30329-2208 |
Second Address | Atlanta, GA 30329-2208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 31/07/2014 |