Provider Demographics
NPI:1689856494
Name:ROBERT BARNETT D.C. LLC
Entity Type:Organization
Organization Name:ROBERT BARNETT D.C. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:860-445-5000
Mailing Address - Street 1:258 ROUTE 12
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-3415
Mailing Address - Country:US
Mailing Address - Phone:860-445-5000
Mailing Address - Fax:860-415-0201
Practice Address - Street 1:258 ROUTE 12
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-3415
Practice Address - Country:US
Practice Address - Phone:860-445-5000
Practice Address - Fax:860-415-0201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTCO2845Medicare PIN