Healthcare Provider Details

I. General information

NPI: 1912159864
Provider Name (Legal Business Name): WILLIAM J BARABAS P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2008
Last Update Date: 10/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

244 US HWY 68 EAST
BENTON KY
42025
US

IV. Provider business mailing address

5050 VILLAGE SQUARE DR. STE. B
PADUCAH KY
42001
US

V. Phone/Fax

Practice location:
  • Phone: 270-527-4322
  • Fax: 270-527-4322
Mailing address:
  • Phone: 270-443-0681
  • Fax: 270-442-7948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004358
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: