Provider Demographics
NPI:1457338238
Name:BARRON, JAMES T (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:T
Last Name:BARRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:505 INSIGNIA DR
Mailing Address - Street 2:
Mailing Address - City:HERRIN
Mailing Address - State:IL
Mailing Address - Zip Code:62948-4061
Mailing Address - Country:US
Mailing Address - Phone:618-942-3771
Mailing Address - Fax:618-942-3772
Practice Address - Street 1:505 INSIGNIA DR
Practice Address - Street 2:
Practice Address - City:HERRIN
Practice Address - State:IL
Practice Address - Zip Code:62948-4061
Practice Address - Country:US
Practice Address - Phone:618-942-3771
Practice Address - Fax:618-942-3772
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC37197Medicare UPIN