Healthcare Provider Details

I. General information

NPI: 1497750319
Provider Name (Legal Business Name): JOSEPH A BARRETT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 01/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1345 NW WALL ST SUITE 200
BEND OR
97701-1972
US

IV. Provider business mailing address

1345 NW WALL ST SUITE 200
BEND OR
97701-1972
US

V. Phone/Fax

Practice location:
  • Phone: 541-330-2103
  • Fax: 541-382-6576
Mailing address:
  • Phone: 541-382-1395
  • Fax: 541-382-6576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD24477
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: