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NPI Code Detail

MEDICARE: MARY JANE T BARTH MD

MEDICARE:   MARY JANE T BARTH  MD
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
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician036090133IL
2208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician51254AZ

General Provider Information

NPI Number : 1376509281
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY JANE T BARTH MD
Provider Business Mailing Address
First Line : 1501 N CAMPBELL AVE
Second Line : DEPARTMENT OF SURGERY SUITE 4302
City : TUCSON
State : AZ
Zip : 85724-5071
Country : US
Telephone Number : 520-626-9752
Fax Number : 520-626-4042
Provider Business Practice Location Address
First Line : 1501 N CAMPBELL AVE
Second Line : DEPARTMENT OF SURGERY SUITE 4302
City : TUCSON
State : AZ
Zip : 85724-5071
Country : US
Telephone Number : 520-626-9752
Fax Number : 520-626-4042
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2006
Last Update Date : 11/16/2016

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