Provider Demographics
NPI:1003997974
Name:BARRETT, JAMES ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROBERT
Last Name:BARRETT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3002 US HIGHWAY 641 N
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:KY
Mailing Address - Zip Code:42025-7464
Mailing Address - Country:US
Mailing Address - Phone:270-527-7033
Mailing Address - Fax:270-527-6826
Practice Address - Street 1:3002 US HIGHWAY 641 N
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025-7464
Practice Address - Country:US
Practice Address - Phone:270-527-7033
Practice Address - Fax:270-527-6826
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4497111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85001105Medicaid
KY7227Medicare ID - Type UnspecifiedGROUP NUMBER
KY0722701Medicare PIN
KY85001105Medicaid