Provider Demographics
NPI:1326160144
Name:BARBIN, JENNIFER FERNANDO (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:FERNANDO
Last Name:BARBIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:965 MATTOX DR
Mailing Address - Street 2:
Mailing Address - City:SULLIVAN
Mailing Address - State:MO
Mailing Address - Zip Code:63080-2365
Mailing Address - Country:US
Mailing Address - Phone:573-860-6000
Mailing Address - Fax:
Practice Address - Street 1:965 MATTOX DR
Practice Address - Street 2:
Practice Address - City:SULLIVAN
Practice Address - State:MO
Practice Address - Zip Code:63080-2365
Practice Address - Country:US
Practice Address - Phone:573-860-6000
Practice Address - Fax:573-860-6016
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS946629207R00000X
MO2008005504207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine