Individual
MR. JERRY OWEN BARRETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
26303 SAVINGS CENTER DR, ARDMORE, TN 38449-3273
(931) 427-3565
(931) 427-8111
Mailing address
PO BOX 235, ARDMORE, TN 38449-0235
(931) 427-3565
(931) 427-8111
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD011762
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000055623
BLUE CROSS
TN
05
—
000810174
—
AL
05
—
3170577
—
TN
Enumeration date
08/30/2005
Last updated
05/26/2011
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