Provider Demographics
NPI:1558373118
Name:BARTON, MELISSA LEWIS (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LEWIS
Last Name:BARTON
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:PO BOX 846
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38025-0846
Mailing Address - Country:US
Mailing Address - Phone:731-285-1119
Mailing Address - Fax:731-285-1195
Practice Address - Street 1:1365 FLOWERING DOGWOOD LN
Practice Address - Street 2:STE. F
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-2884
Practice Address - Country:US
Practice Address - Phone:731-285-1119
Practice Address - Fax:731-285-1195
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN385462082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
C76523Medicare UPIN