Provider Demographics
NPI:1831856608
Name:BARRETT, JAMES
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:BARRETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1146 S WAUKEGAN RD # 157
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-6731
Mailing Address - Country:US
Mailing Address - Phone:574-386-7424
Mailing Address - Fax:
Practice Address - Street 1:703 W HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6938
Practice Address - Country:US
Practice Address - Phone:715-717-4944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant