Provider Demographics
NPI:1942394929
Name:BARCUS, MARY-BETH PING (PT, CERT MDT)
Entity Type:Individual
Prefix:MRS
First Name:MARY-BETH
Middle Name:PING
Last Name:BARCUS
Suffix:
Gender:F
Credentials:PT, CERT MDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-1229
Mailing Address - Country:US
Mailing Address - Phone:859-253-9953
Mailing Address - Fax:859-253-9984
Practice Address - Street 1:508 MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-1229
Practice Address - Country:US
Practice Address - Phone:859-253-9953
Practice Address - Fax:859-253-9984
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004522225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY5016610Medicare ID - Type Unspecified