Healthcare Provider Details

I. General information

NPI: 1245646884
Provider Name (Legal Business Name): JEROME BARRON D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2014
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 PETERS ROAD SUITE 200 AND 203
LITITZ PA
17543-7682
US

IV. Provider business mailing address

51 PETERS ROAD SUITE 200 AND 203
LITITZ PA
17543-7682
US

V. Phone/Fax

Practice location:
  • Phone: 717-627-7675
  • Fax: 717-627-7676
Mailing address:
  • Phone: 717-627-7675
  • Fax: 717-627-7676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS023901
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberOS023901
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: