Provider Demographics
NPI:1568669943
Name:M. THERESE BARRETT, MD PC
Entity Type:Organization
Organization Name:M. THERESE BARRETT, MD PC
Other - Org Name:CENTENNIAL WOMEN'S HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:T
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-651-2800
Mailing Address - Street 1:231 E 9TH AVE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-4686
Mailing Address - Country:US
Mailing Address - Phone:303-651-2800
Mailing Address - Fax:
Practice Address - Street 1:231 E 9TH AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80504-4686
Practice Address - Country:US
Practice Address - Phone:303-651-2800
Practice Address - Fax:303-774-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1568669943OtherGROUP