Provider Demographics
NPI:1871656611
Name:GUILLETTE, BARBARA JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:JEAN
Last Name:GUILLETTE
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 1:3520 POST RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-7140
Mailing Address - Country:US
Mailing Address - Phone:401-921-5800
Mailing Address - Fax:401-921-5826
Practice Address - Street 1:3520 POST RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-7140
Practice Address - Country:US
Practice Address - Phone:401-921-5800
Practice Address - Fax:401-921-5826
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD07726207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1000210OtherUNITED HEALTHPLAN
RI27529OtherNEIGHBORHOOD HEALTH PLAN
RI007726OtherTUFTS
RIBG28625Medicaid
RI004209OtherBLUECHIP
RIBG28625Medicaid