Provider Demographics
NPI:1750463220
Name:BARTH, ELIZABETH N (BC-HIS)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:N
Last Name:BARTH
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 S MAIN ST
Mailing Address - Street 2:PO BOX 451506
Mailing Address - City:GROVE
Mailing Address - State:OK
Mailing Address - Zip Code:74344-2864
Mailing Address - Country:US
Mailing Address - Phone:918-786-4565
Mailing Address - Fax:918-786-4531
Practice Address - Street 1:1008 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-2864
Practice Address - Country:US
Practice Address - Phone:918-786-4565
Practice Address - Fax:918-786-4531
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK410237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1043160001Medicare NSC