Provider Demographics
NPI:1902223985
Name:BARTON, SHANNA MARIE (MD)
Entity Type:Individual
Prefix:MISS
First Name:SHANNA
Middle Name:MARIE
Last Name:BARTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:571 S FLOYD ST STE 321
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-3816
Mailing Address - Country:US
Mailing Address - Phone:859-351-8754
Mailing Address - Fax:
Practice Address - Street 1:411 E CHESTNUT ST # 4B5A
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1713
Practice Address - Country:US
Practice Address - Phone:502-588-2348
Practice Address - Fax:502-588-2334
Is Sole Proprietor?:No
Enumeration Date:2014-03-27
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY514462080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100359930Medicaid
KYK378150OtherMEDICARE
IN300049061Medicaid