Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 171290 | OR |
NPI | 1003179383 |
---|---|
Provider Name | Jordan L Barnhart |
First Address | Salem, OR 97304-2940 |
Second Address | Salem, OR 97301-3905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2012 |
Last Update Date | 29/01/2016 |