1942738844 NPI number — KATHERINE BARTON MD, PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942738844 NPI number — KATHERINE BARTON MD, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KATHERINE BARTON MD, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942738844
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/02/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9869 S VIEW DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROGERS
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72756-8174
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2900 MEDICAL CENTER PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BENTONVILLE
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72712-3204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
479-553-1620
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/23/2017

Additional Information

Authorized Official

Authorized Official Last Name:
BARTON
Authorized Official First Name:
KATHERINE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
479-877-9234

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  E-5625 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 200392890 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 90001082 . This is a "BCBS" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 000000278474 . This is a "ANTHEM BCBS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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