Provider Demographics
NPI:1083184667
Name:BARRON, SCARLET (EXERCISE PHYSIOLOGYS)
Entity Type:Individual
Prefix:
First Name:SCARLET
Middle Name:
Last Name:BARRON
Suffix:
Gender:F
Credentials:EXERCISE PHYSIOLOGYS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 TOWLE ST
Mailing Address - Street 2:
Mailing Address - City:POTOSI
Mailing Address - State:MO
Mailing Address - Zip Code:63664
Mailing Address - Country:US
Mailing Address - Phone:573-631-8978
Mailing Address - Fax:
Practice Address - Street 1:223 W. MAIN ST.
Practice Address - Street 2:
Practice Address - City:PARK HILLS
Practice Address - State:MO
Practice Address - Zip Code:63601
Practice Address - Country:US
Practice Address - Phone:573-631-8978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO794002208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice