Provider Demographics
NPI:1265640577
Name:BARRETT, BRET J (MD)
Entity Type:Individual
Prefix:DR
First Name:BRET
Middle Name:J
Last Name:BARRETT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:965 RIDGE LAKE BLVD
Mailing Address - Street 2:STE 103
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-9446
Mailing Address - Country:US
Mailing Address - Phone:901-227-3255
Mailing Address - Fax:901-227-8591
Practice Address - Street 1:1200 N STATE ST
Practice Address - Street 2:SUITE 500
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-2000
Practice Address - Country:US
Practice Address - Phone:601-352-2273
Practice Address - Fax:601-714-3415
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2018-03-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS20210207RI0200X
TN40272207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06903314Medicaid
MS06903314Medicaid