Healthcare Provider Details

I. General information

NPI: 1518897503
Provider Name (Legal Business Name): TODD LEE BARGER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E GRANGER RD
INDEPENDENCE OH
44131-6704
US

IV. Provider business mailing address

600 E GRANGER RD
INDEPENDENCE OH
44131-6704
US

V. Phone/Fax

Practice location:
  • Phone: 888-586-7168
  • Fax:
Mailing address:
  • Phone: 888-586-7168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number007723
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: