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NPI Code Detail

MEDICARE: MS. KATHLEEN WHITLEY BARBER PA-C

MEDICARE: MS. KATHLEEN WHITLEY BARBER PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Y00000XOtolaryngology Physician0010-12393NC
2363A00000XPhysician Assistant0010-12393NC

General Provider Information

NPI Number : 1043943863
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHLEEN WHITLEY BARBER PA-C
Provider Business Mailing Address
First Line : 656 S SUNSET DR
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-3820
Country : US
Telephone Number : 336-480-5384
Fax Number :
Provider Business Practice Location Address
First Line : 131 MILLER ST
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-2508
Country : US
Telephone Number : 336-716-4161
Fax Number : 336-716-5560
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2022
Last Update Date : 11/23/2022

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