Provider Demographics
NPI:1073543260
Name:BARTLETT, DONALD II (PA)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:
Last Name:BARTLETT
Suffix:II
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 GROVELAND ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6674
Mailing Address - Country:US
Mailing Address - Phone:978-373-3851
Mailing Address - Fax:978-521-6542
Practice Address - Street 1:288 GROVELAND ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6674
Practice Address - Country:US
Practice Address - Phone:978-373-3851
Practice Address - Fax:978-521-6542
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA187342363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAP0372Medicare ID - Type Unspecified