=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386865517
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES E BARTON LADC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/02/2007
-----------------------------------------------------
Last Update Date | 12/02/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1301 SE 59TH ST
-----------------------------------------------------
City | OKLAHOMA CITY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73129-7307
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-672-3033
-----------------------------------------------------
Fax | 405-672-8371
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18617 COUNCIL AVE
-----------------------------------------------------
City | LINDSAY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73052-3444
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-344-7398
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | 442
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------