Provider Demographics
NPI:1346298353
Name:BARLET, ELIZABETH M (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:BARLET
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 1:1515 HAZEL ST
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-2850
Mailing Address - Country:US
Mailing Address - Phone:417-358-0188
Mailing Address - Fax:417-358-0189
Practice Address - Street 1:1515 HAZEL ST
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-2850
Practice Address - Country:US
Practice Address - Phone:417-358-0188
Practice Address - Fax:417-358-0189
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8J24207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO203312038Medicaid
MO14620OtherBLUE CHOICE
MO174436OtherHEALTHLINK
MO14620OtherBLUE SHIELD
MO701557OtherUNITED HEALTHCARE
MO033011938Medicare PIN
MO900655236Medicare PIN
MOP00024204Medicare PIN
MO174436OtherHEALTHLINK