Provider Demographics
NPI:1083148738
Name:BARBER, EARL JAMES II (STUDENT)
Entity Type:Individual
Prefix:MR
First Name:EARL
Middle Name:JAMES
Last Name:BARBER
Suffix:II
Gender:M
Credentials:STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2113 PUTNAM LN
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-3655
Mailing Address - Country:US
Mailing Address - Phone:629-203-4860
Mailing Address - Fax:
Practice Address - Street 1:2113 PUTNAM LN
Practice Address - Street 2:
Practice Address - City:MT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3655
Practice Address - Country:US
Practice Address - Phone:629-203-4860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program