Provider Demographics
NPI:1497828529
Name:BARTEE, HARRY ALBERT SR (MD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:ALBERT
Last Name:BARTEE
Suffix:SR
Gender:M
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:PO BOX 607
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MS
Mailing Address - Zip Code:39095
Mailing Address - Country:US
Mailing Address - Phone:662-472-2970
Mailing Address - Fax:662-472-2920
Practice Address - Street 1:223 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:GOODMAN
Practice Address - State:MS
Practice Address - Zip Code:39079
Practice Address - Country:US
Practice Address - Phone:662-472-2970
Practice Address - Fax:662-472-2970
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS07623207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00017521Medicaid
C48027Medicare UPIN