Individual
JONATHAN MACK BARHAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
3418 MEDICAL PARK DR, SUITE 5, MONROE, LA 71203-2376
(318) 388-8190
(318) 329-5981
Mailing address
3418 MEDICAL PARK DR, SUITE 5, MONROE, LA 71203-2376
(318) 388-8190
(318) 329-5981
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
07884R
LA
207V00000X
Obstetrics & Gynecology Physician
F0865
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1394831
—
LA
Enumeration date
07/07/2005
Last updated
07/08/2007
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