Provider Demographics
NPI:1285849661
Name:TRI COUNTY MEDICAL
Entity Type:Organization
Organization Name:TRI COUNTY MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:BARBER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:586-773-1823
Mailing Address - Street 1:210 W HIGHLAND RD
Mailing Address - Street 2:STE 102
Mailing Address - City:HIGHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48357-4573
Mailing Address - Country:US
Mailing Address - Phone:586-773-1823
Mailing Address - Fax:586-773-1211
Practice Address - Street 1:210 W HIGHLAND RD
Practice Address - Street 2:STE 102
Practice Address - City:HIGHLAND
Practice Address - State:MI
Practice Address - Zip Code:48357-4573
Practice Address - Country:US
Practice Address - Phone:586-773-1823
Practice Address - Fax:586-773-1211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJB012525207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4734373Medicaid
MI0156312915OtherBCBS
MI=========OtherTAX ID
MI4734373Medicaid
MIH11546Medicare UPIN