MEDICARE: KENNETH J BARKETT M.D.

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	207W00000X	Ophthalmology Physician	MD36149	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	180015037	OTHER	MO	RAILROAD MEDICARE PART B

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	43074141063801A076	OTHER	MO	TRICARE NUMBER
4	25949	OTHER	MO	BCBS NUMBER
5	189287	OTHER	MO	HEALTHLINK NUMBER
6	1812734	OTHER	MO	FIRST HEALTH/CCN NUMBER

General Provider Information

NPI Number	:	1952389462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH J BARKETT M.D.

Provider Business Mailing Address
First Line	:	PO BOX 801143
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64180-1143
Country	:	US
Telephone Number	:	573-331-5583
Fax Number	:	573-331-5079

Provider Business Practice Location Address
First Line	:	1012 N MAIN ST
Second Line	:
City	:	SIKESTON
State	:	MO
Zip	:	63801-5044
Country	:	US
Telephone Number	:	573-431-0330
Fax Number	:	573-471-0461

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

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	12/29/2020

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Directions to “ KENNETH J BARKETT M.D.” Practice Location

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