Barrientos, Joel Kwan

Barrientos, Joel Kwan is an sole proprietor health care provider with primary practice located at 1054 Martin Luther King Drive Suite 121, Centralia IL 62801-3065. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Barrientos, Joel Kwan can be contacted via phone (618) 533-3222.

Contact Information

Primary practice address
1054 Martin Luther King Drive Suite 121 Centralia IL 62801-3065
Phone: (618) 533-3222
Fax: (618) 533-9606
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 036069061 Illinois

Profile Details

NPI number 1437233632
LBN Legal business name Barrientos, Joel Kwan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 24th, 2006
Last updated Oct 12th, 2011 - about 13 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 1437233632 NPPES
Illinois Other 0006100112 BLUE CROSS BLUE SHIELD
Illinois MEDICAID 036069061 BLUE CROSS BLUE SHIELD

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