Healthcare Provider Details

I. General information

NPI: 1881689859
Provider Name (Legal Business Name): GEORGE L BARRETT, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 10/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HIGHLAND ST SUITE 101
MILTON MA
02186-3881
US

IV. Provider business mailing address

100 HIGHLAND ST SUITE 101
MILTON MA
02186-3881
US

V. Phone/Fax

Practice location:
  • Phone: 617-696-0082
  • Fax: 617-696-1933
Mailing address:
  • Phone: 617-696-0082
  • Fax: 617-696-1933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number78403
License Number StateMA

VIII. Authorized Official

Name: GEORGE L BARRETT
Title or Position: PRESIDENT
Credential: M.D.,P.C.
Phone: 617-696-0082