1902942899 NPI number — MRS. BARBARA GAIL SIEGEL MSCCC SP

Table of content: MRS. BARBARA GAIL SIEGEL MSCCC SP (NPI 1902942899)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902942899 NPI number — MRS. BARBARA GAIL SIEGEL MSCCC SP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SIEGEL
Provider First Name:
BARBARA
Provider Middle Name:
GAIL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSCCC SP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HEILBRUNN SIEGEL
Provider Other First Name:
BARBARA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1902942899
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9048 YELLOWWOOD CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDPLS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46260
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-432-0584
Provider Business Mailing Address Fax Number:
317-872-2080

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MARION COUNTY INDPLS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDPLS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46260
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-432-0584
Provider Business Practice Location Address Fax Number:
317-872-2080
Provider Enumeration Date:
01/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  00971341 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200718780A . This is a "1ST STEPS PROVIDER" identifier . This identifiers is of the category "OTHER".




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