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General NPI Number Information
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NPI Number | 1588852115
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Entity Type | Organization
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Legal Business Name | THEODORE BARTON
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 03/18/2020
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Provider Practice Location Address
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Address Line | 35670 KENAI SPUR HWY SUITE 101A
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City | SOLDOTNA
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State | AK
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Zip | 99669-7626
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Country | US
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Telephone | 907-262-2602
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Fax | 907-262-5794
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Provider Business Mailing Address
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Address Line | 35670 KENAI SPUR HWY SUITE 101A
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City | SOLDOTNA
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State | AK
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Zip | 99669-7626
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Country | US
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Telephone | 907-262-2602
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Fax | 907-262-5794
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | JENNY RATKY
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Credential |
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Telephone | 907-262-2602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 5721
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License Number State | AK
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