Healthcare Provider Details

I. General information

NPI: 1285605097
Provider Name (Legal Business Name): RONALD TIMOTHY BARRETT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 N 3RD AVE STE 110
SANDPOINT ID
83864-1511
US

IV. Provider business mailing address

PO BOX 1343
SANDPOINT ID
83864-0863
US

V. Phone/Fax

Practice location:
  • Phone: 208-265-3342
  • Fax: 208-255-3422
Mailing address:
  • Phone: 208-263-1431
  • Fax: 208-265-1278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMD166370
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: