MEDICARE: JEANINEA PILAR BARE DO

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
1	2084P0800X	Psychiatry Physician	335907-01	NY
2	2084P0800X	Psychiatry Physician	34.017948	OH
3	2084P0800X	Psychiatry Physician	5786	TN

General Provider Information

NPI Number	:	1083111066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANINEA PILAR BARE DO

Provider Business Mailing Address
First Line	:	200 MULLINS DR
Second Line	:
City	:	LEBANON
State	:	OR
Zip	:	97355-3983
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6200 HOSPITALITY DR FL 1
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-5023
Country	:	US
Telephone Number	:	917-634-5311
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2018
Last Update Date	:	08/04/2025

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Directions to “ JEANINEA PILAR BARE DO” Practice Location

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