Healthcare Provider Details

I. General information

NPI: 1386087302
Provider Name (Legal Business Name): JESSICA LEIGH BARRETT D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2013
Last Update Date: 01/25/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 OLENTANGY RIVER RD
COLUMBUS OH
43214-3908
US

IV. Provider business mailing address

805 GLYNWOOD RD
WAPAKONETA OH
45895-1131
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-3322
  • Fax: 614-566-1073
Mailing address:
  • Phone: 419-303-0630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number34.013366
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: