Provider Demographics
NPI:1578904710
Name:BARRON FAMILY MEDICINE
Entity Type:Organization
Organization Name:BARRON FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:O'NEILL
Authorized Official - Last Name:BARRON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:314-667-5276
Mailing Address - Street 1:8515 DELMAR BLVD STE 217
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-2168
Mailing Address - Country:US
Mailing Address - Phone:314-667-5276
Mailing Address - Fax:314-677-3838
Practice Address - Street 1:8515 DELMAR BLVD STE 217
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-2168
Practice Address - Country:US
Practice Address - Phone:314-667-5276
Practice Address - Fax:314-677-3838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-16
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care