MEDICARE: DR. RONALD JAMES BARRETTE D.O.

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	208600000X	Surgery Physician	02001519A	IN
2	208600000X	Surgery Physician	5101006854	MI
3	208600000X	Surgery Physician	3898	AZ
4	208600000X	Surgery Physician	0102201501	VA
5	2086S0129X	Vascular Surgery Physician	02001519A	IN
6	2086S0129X	Vascular Surgery Physician	5101006854	MI
7	2086S0129X	Vascular Surgery Physician	3898	AZ
8	2086S0129X	Vascular Surgery Physician	0102201501	VA
9	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	02001519A	IN
10	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	5101006854	MI
11	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	3898	AZ
12	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	0102201501	VA
13	208600000X	Surgery Physician	DO611	AL
14	2086S0129X	Vascular Surgery Physician	DO611	AL
15	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	DO611	AL

General Provider Information

NPI Number	:	1942256623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD JAMES BARRETTE D.O.

Provider Business Mailing Address
First Line	:	108 NEW CASTLE CIR
Second Line	:
City	:	SELMA
State	:	AL
Zip	:	36701-6833
Country	:	US
Telephone Number	:	334-874-7705
Fax Number	:

Provider Business Practice Location Address
First Line	:	1810 STADIUM DR
Second Line	:	SUITE 130
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-3100
Country	:	US
Telephone Number	:	334-448-4163
Fax Number	:	334-448-4228

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

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	02/04/2016

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