Provider Demographics
NPI:1619278124
Name:BARRON, SCOTT MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:MICHAEL
Last Name:BARRON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52349-2506
Mailing Address - Country:US
Mailing Address - Phone:319-472-4668
Mailing Address - Fax:888-421-6618
Practice Address - Street 1:205 W 4TH ST
Practice Address - Street 2:
Practice Address - City:VINTON
Practice Address - State:IA
Practice Address - Zip Code:52349-1123
Practice Address - Country:US
Practice Address - Phone:319-472-4668
Practice Address - Fax:888-421-6618
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-15
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007364111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA007364OtherSTATE LICENSE