Healthcare Provider Details

I. General information

NPI: 1871625368
Provider Name (Legal Business Name): ERIC GARN BARRETT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2007
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1162 TWIN STACKS DR
DALLAS PA
18612-8505
US

IV. Provider business mailing address

1162 TWIN STACKS DR
DALLAS PA
18612-8505
US

V. Phone/Fax

Practice location:
  • Phone: 570-255-4728
  • Fax:
Mailing address:
  • Phone: 570-255-4728
  • Fax: 570-310-1448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number41177
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2080B0002X
TaxonomyPediatric Obesity Medicine Physician
License NumberMD462439
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License NumberMD462439
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License NumberMD462439
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: