Provider Demographics
NPI:1033360565
Name:BARTON, TEJAY WAYNE (HS2)
Entity Type:Individual
Prefix:MR
First Name:TEJAY
Middle Name:WAYNE
Last Name:BARTON
Suffix:
Gender:M
Credentials:HS2
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7357 BUCKWHEAT TREE RD
Mailing Address - Street 2:
Mailing Address - City:VANCLEAVE
Mailing Address - State:MS
Mailing Address - Zip Code:39565-5060
Mailing Address - Country:US
Mailing Address - Phone:251-441-6240
Mailing Address - Fax:251-441-5498
Practice Address - Street 1:101 SOUTH BROAD ST.
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36615
Practice Address - Country:US
Practice Address - Phone:251-441-6240
Practice Address - Fax:125-144-1549
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider