Healthcare Provider Details

I. General information

NPI: 1174526891
Provider Name (Legal Business Name): PHILIP G BARTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 06/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3233 SW 33RD RD STE 101
OCALA FL
34474-8468
US

IV. Provider business mailing address

3233 SW 33RD RD STE 101
OCALA FL
34474-8468
US

V. Phone/Fax

Practice location:
  • Phone: 352-237-2322
  • Fax: 352-237-2456
Mailing address:
  • Phone: 352-237-2322
  • Fax: 352-237-2456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME66093
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: