Barra, Jeffrey R
Barra, Jeffrey R is an individual health care provider with primary practice located at 5100 Lake Ter Ne Suite Wc, Mount Vernon IL 62864-9665. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Barra, Jeffrey R can be contacted via phone (618) 899-5001.Contact Information
Primary practice address
5100 Lake Ter Ne Suite Wc
Mount Vernon IL 62864-9665
Phone: (618) 899-5001
Fax: (618) 242-5152
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036107295 | Illinois |
Profile Details
| NPI number | 1679548713 |
|---|---|
| LBN Legal business name | Barra, Jeffrey R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 22nd, 2006 |
| Last updated | May 13th, 2015 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679548713 | NPPES |
| Illinois | MEDICAID | 036107295 |
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