Provider Demographics
NPI:1225356751
Name:BARTON, NICHOLE V (DO)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:V
Last Name:BARTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 W HARRISBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17057-4848
Mailing Address - Country:US
Mailing Address - Phone:717-944-0491
Mailing Address - Fax:
Practice Address - Street 1:5400 CHAMBERS HILL RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-2545
Practice Address - Country:US
Practice Address - Phone:717-564-5400
Practice Address - Fax:717-564-7859
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-009805207R00000X
PAOS019454207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103535780Medicaid