Provider Demographics
NPI:1407263056
Name:BARRON, MARIE JOYCE (PT, OCS, CMT)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:JOYCE
Last Name:BARRON
Suffix:
Gender:F
Credentials:PT, OCS, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7545 AIRWAYS BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-5806
Mailing Address - Country:US
Mailing Address - Phone:901-759-3208
Mailing Address - Fax:
Practice Address - Street 1:7545 AIRWAYS BLVD
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-5806
Practice Address - Country:US
Practice Address - Phone:901-759-3208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN207XX0005X207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine