Provider Demographics
NPI:1679965289
Name:BARRICK, CARL (DO)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:
Last Name:BARRICK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 MEDINA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-5913
Mailing Address - Country:US
Mailing Address - Phone:330-239-4350
Mailing Address - Fax:330-239-4584
Practice Address - Street 1:1133 MEDINA RD STE 100
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-5913
Practice Address - Country:US
Practice Address - Phone:330-239-4350
Practice Address - Fax:330-239-4584
Is Sole Proprietor?:No
Enumeration Date:2015-02-19
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.013766207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology