Provider Demographics
NPI:1649512286
Name:BARTON, JEFF ROBERT (DO)
Entity type:Individual
Prefix:DR
First Name:JEFF
Middle Name:ROBERT
Last Name:BARTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 253
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83701-0253
Mailing Address - Country:US
Mailing Address - Phone:650-544-8888
Mailing Address - Fax:
Practice Address - Street 1:2131 SOUTH BONITO WAY
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-8371
Practice Address - Country:US
Practice Address - Phone:650-544-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO178888207R00000X
IDO-0971207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine