Provider Demographics
NPI:1215080296
Name:BARNETT, PAMELA WALTON (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:WALTON
Last Name:BARNETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1729 SPRING HILL AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36604-1408
Mailing Address - Country:US
Mailing Address - Phone:251-690-7726
Mailing Address - Fax:251-405-0096
Practice Address - Street 1:1729 SPRING HILL AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1408
Practice Address - Country:US
Practice Address - Phone:251-690-7726
Practice Address - Fax:251-405-0096
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL44722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1580155OtherMEDICARE COMPLETE
AL880211834OtherMEDICARE RAILROAD
AL000078074Medicaid
AL51078074OtherBLUE CROSS BLUE SHIELD
AL360579900OtherUS DEPT OF LABOR
AL1580155OtherMEDICARE COMPLETE
ALE93700Medicare UPIN