Healthcare Provider Details

I. General information

NPI: 1255269734
Provider Name (Legal Business Name): BRETT JOSEPH BARGER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3D RECON BN OPC 563 BOX 58
FPO AP
96388-9001
US

IV. Provider business mailing address

4662 E STATE ROAD 252
FRANKLIN IN
46131-8158
US

V. Phone/Fax

Practice location:
  • Phone: 315-625-7035
  • Fax:
Mailing address:
  • Phone: 317-797-2775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: