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General NPI Number Information
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NPI Number | 1295737963
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Entity Type | Individual
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Provider Name | KERN LEE BARROW PA
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Gender | Male
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 12/30/2016
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Provider Practice Location Address
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Address Line | 112 MEDICAL VILLAGE DR SUITE G
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City | WALLACE
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State | NC
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Zip | 28466-1665
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Country | US
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Telephone | 910-285-0333
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Fax | 910-285-0336
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Provider Business Mailing Address
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Address Line | PO BOX 602484
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City | CHARLOTTE
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State | NC
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Zip | 28260-2484
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Country | US
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Telephone | 910-285-0333
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Fax | 910-285-0336
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 102509
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 102509
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License Number State | NC
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