Provider Demographics
NPI:1598460503
Name:BARNARD, JACLYN ADDISON (DO)
Entity Type:Individual
Prefix:
First Name:JACLYN
Middle Name:ADDISON
Last Name:BARNARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 E PECAN ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-5916
Mailing Address - Country:US
Mailing Address - Phone:903-744-0816
Mailing Address - Fax:
Practice Address - Street 1:311 E MATTHEWS AVE
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-3125
Practice Address - Country:US
Practice Address - Phone:903-744-0816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program