Provider Demographics
NPI:1538114681
Name:BARRON, MARJORIE B (MD)
Entity Type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:B
Last Name:BARRON
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 1:1504 KENSINGTON DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-6040
Mailing Address - Country:US
Mailing Address - Phone:865-694-4527
Mailing Address - Fax:
Practice Address - Street 1:1504 KENSINGTON DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-6040
Practice Address - Country:US
Practice Address - Phone:865-694-4527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD016899207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3019789Medicaid
TNP00312135OtherRAILROAD MEDICARE
TN0077832OtherBLUE CROSS
TN3019789Medicare PIN