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NPI Code Detail

MEDICARE: JO ANN BARTLEY PHD

MEDICARE: JO ANN BARTLEY PHD
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
1103T00000XPsychologist523AK

General Provider Information

NPI Number : 1912112012
Entity Type Code : Individual
Provider Name (Legal Business Name) : JO ANN BARTLEY PHD
Provider Business Mailing Address
First Line : 4201 TUDOR CENTRE DR STE 320
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-5916
Country : US
Telephone Number : 907-729-6337
Fax Number :
Provider Business Practice Location Address
First Line : 4000 SAN ERNESTO AVE
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-2874
Country : US
Telephone Number : 907-729-5056
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2007
Last Update Date : 07/08/2007

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Directions to “ JO ANN BARTLEY PHD” Practice Location

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