Provider Demographics
NPI:1720298060
Name:BARTLETT, SYLVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SYLVAN
Middle Name:
Last Name:BARTLETT
Suffix:
Gender:M
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:PO BOX 338
Mailing Address - Street 2:
Mailing Address - City:CRANE
Mailing Address - State:TX
Mailing Address - Zip Code:79731-0338
Mailing Address - Country:US
Mailing Address - Phone:432-582-2344
Mailing Address - Fax:
Practice Address - Street 1:1330 E 8TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4702
Practice Address - Country:US
Practice Address - Phone:432-582-2344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7810207Y00000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM343800702Medicare UPIN
938531084Medicare ID - Type Unspecified