Healthcare Provider Details

I. General information

NPI: 1366442691
Provider Name (Legal Business Name): JAMES H BARNETT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 12/01/2009
Certification Date:
Deactivation Date: 03/22/2006
Reactivation Date: 03/28/2006

III. Provider practice location address

2600 N MAYFAIR RD SUITE 810
WAUWATOSA WI
53226-1309
US

IV. Provider business mailing address

2600 N MAYFAIR RD SUITE 810
WAUWATOSA WI
53226-1309
US

V. Phone/Fax

Practice location:
  • Phone: 414-771-1122
  • Fax:
Mailing address:
  • Phone: 414-771-1122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number22957-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: