Provider Demographics
NPI:1447577549
Name:BARRETT, JOHN FISHER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FISHER
Last Name:BARRETT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4810 FOX CRK E
Mailing Address - Street 2:APT 180
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-4938
Mailing Address - Country:US
Mailing Address - Phone:248-229-8355
Mailing Address - Fax:
Practice Address - Street 1:4810 FOX CRK E
Practice Address - Street 2:APT 180
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-4938
Practice Address - Country:US
Practice Address - Phone:248-229-8355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-28
Last Update Date:2010-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302036522183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist