Provider Demographics
NPI:1225245921
Name:BARRIOCANAL, JOSE ALBERTO (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ALBERTO
Last Name:BARRIOCANAL
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
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Mailing Address - Street 1:975 E 3RD ST
Mailing Address - Street 2:BOX 376
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2147
Mailing Address - Country:US
Mailing Address - Phone:423-778-6213
Mailing Address - Fax:423-778-6299
Practice Address - Street 1:975 E 3RD ST
Practice Address - Street 2:BOX 376
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2147
Practice Address - Country:US
Practice Address - Phone:423-778-6213
Practice Address - Fax:423-778-6299
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2018-10-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDP26885207UN0902X
TN519332085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ007705Medicaid