Healthcare Provider Details

I. General information

NPI: 1932207198
Provider Name (Legal Business Name): JASON KYLE BARNETT PHARM. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 N AIRPORT RD
JASPER AL
35504-7068
US

IV. Provider business mailing address

2362 PROSPECT RD
NAUVOO AL
35578-4812
US

V. Phone/Fax

Practice location:
  • Phone: 205-221-4564
  • Fax: 205-221-4555
Mailing address:
  • Phone: 205-924-4796
  • Fax: 205-221-4555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13636
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: