MEDICARE: DR. JAMES T BARR DC, CCSP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2177-012	WI
2	111N00000X	Chiropractor	2310	MN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	CJ7409	OTHER		RAILROAD MEDICARE GROUP
5	350022884	OTHER	WI	RAILROAD MEDICARE
7	P00775087	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	24549	OTHER	WI	SECURITY HEALTH PLAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4404853	OTHER		MEDICA
6	3AN69BA	OTHER	MN	BCBS MN
8	CC1784A	OTHER		CHIROCARE

General Provider Information

NPI Number	:	1346346798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES T BARR DC, CCSP

Provider Business Mailing Address
First Line	:	4719 BANNING AVE
Second Line	:
City	:	WHITE BEAR LAKE
State	:	MN
Zip	:	55110-3217
Country	:	US
Telephone Number	:	651-429-2279
Fax Number	:	651-429-2361

Provider Business Practice Location Address
First Line	:	4719 BANNING AVE
Second Line	:
City	:	WHITE BEAR LAKE
State	:	MN
Zip	:	55110-3217
Country	:	US
Telephone Number	:	651-429-2279
Fax Number	:	651-429-2361

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	01/27/2010

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Directions to “ DR. JAMES T BARR DC, CCSP” Practice Location

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