Provider Demographics
NPI:1710931456
Name:BETT, BARI JOAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BARI
Middle Name:JOAN
Last Name:BETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 305
Mailing Address - Street 2:
Mailing Address - City:WEST SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44287-0305
Mailing Address - Country:US
Mailing Address - Phone:419-565-7978
Mailing Address - Fax:
Practice Address - Street 1:1036 MOUNT VERNON AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-5537
Practice Address - Country:US
Practice Address - Phone:740-389-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2012-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35055647207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0678431Medicaid
OHH096500Medicare PIN
OHE29866Medicare UPIN
OHBE4105451Medicare PIN
OHBE4105454Medicare PIN