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Individual

JACOB M BARTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
1600 E EVERGREEN ST, MP II STE C, CAMERON, MO 64429-2400
(816) 632-2139
(816) 632-2315
Mailing address
1600 E EVERGREEN ST, CAMERON, MO 64429-2400
(816) 632-2101
(816) 649-3383

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2011003589
MO
363L00000X
Nurse Practitioner
Primary
2016044505
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1295283067
MO
Enumeration date
09/21/2016
Last updated
03/13/2017
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