Bacon, Barry J

Bacon, Barry J is an individual health care provider with primary practice located at 1200 E Columbia Ave , Colville WA 99114-3354. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bacon, Barry J can be contacted via phone (509) 684-3701.

Contact Information

Primary practice address
1200 E Columbia Ave Colville WA 99114-3354
Phone: (509) 684-3701
Fax: (509) 684-5817
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD00027502 Washington

Profile Details

NPI number 1053309146
LBN Legal business name Bacon, Barry J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2005
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053309146 NPPES
Washington MEDICAID 8118986
Washington Other 8924174
Washington Other 62209

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