Provider Demographics
NPI:1952790057
Name:BARONE HEALTH CENTER LLC
Entity Type:Organization
Organization Name:BARONE HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:BARONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-505-4494
Mailing Address - Street 1:403 W COOL DR STE 103
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-6551
Mailing Address - Country:US
Mailing Address - Phone:520-505-4494
Mailing Address - Fax:520-638-7073
Practice Address - Street 1:403 W COOL DR STE 103
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-6551
Practice Address - Country:US
Practice Address - Phone:520-505-4494
Practice Address - Fax:520-638-7073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-13
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8092111N00000X
AZAP7408363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ135917OtherMEDICARE PTAN
AZZ172118OtherMEDICARE PTAN
AZZ175783OtherMEDICARE PTAN
AZZ175782OtherMEDICARE PTAN
AZZ175784OtherMEDICARE PTAN