Healthcare Provider Details

I. General information

NPI: 1922383348
Provider Name (Legal Business Name): DR. ELIZABETH BARRETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2011
Last Update Date: 10/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17202 RICHMOND TURNPIKE
MILFORD VA
22514
US

IV. Provider business mailing address

PO BOX 6 CAROLINE COUNTY HEALTH DEPARTMENT
BOWLING GREEN VA
22427-0006
US

V. Phone/Fax

Practice location:
  • Phone: 804-633-5465
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401413278
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: