Provider Demographics
NPI:1619164902
Name:ROBERT E BARKETT MD INCORPORATED
Entity Type:Organization
Organization Name:ROBERT E BARKETT MD INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:BARKETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-756-2454
Mailing Address - Street 1:341 CLINE AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-1072
Mailing Address - Country:US
Mailing Address - Phone:419-756-2454
Mailing Address - Fax:419-756-1342
Practice Address - Street 1:341 CLINE AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1072
Practice Address - Country:US
Practice Address - Phone:419-756-2454
Practice Address - Fax:419-756-1342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9257671Medicare PIN