Provider Demographics
NPI:1427018720
Name:BARRETT, BRUCE P (MD PHD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:P
Last Name:BARRETT
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:608-829-5485
Mailing Address - Fax:
Practice Address - Street 1:21 S VINE ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53508
Practice Address - Country:US
Practice Address - Phone:608-845-9531
Practice Address - Fax:608-845-5954
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI36882207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine