Provider Demographics
NPI:1134688989
Name:JEAN BARKER MD INC
Entity Type:Organization
Organization Name:JEAN BARKER MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:662-332-4114
Mailing Address - Street 1:1659 E UNION ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38703-3267
Mailing Address - Country:US
Mailing Address - Phone:662-332-4114
Mailing Address - Fax:662-332-1149
Practice Address - Street 1:1659 E UNION ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38703-3267
Practice Address - Country:US
Practice Address - Phone:662-332-4114
Practice Address - Fax:662-332-1149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center