Provider Demographics
NPI:1215935358
Name:BARRETT, BARBARA JEAN (DPM)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:JEAN
Last Name:BARRETT
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:JEAN
Other - Last Name:BRAINERD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:9600 BROADWAY EXT
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-7408
Mailing Address - Country:US
Mailing Address - Phone:405-230-9200
Mailing Address - Fax:405-330-5591
Practice Address - Street 1:400 N BRYANT AVE
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-3206
Practice Address - Country:US
Practice Address - Phone:405-230-9200
Practice Address - Fax:405-230-9245
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK176213ES0103X, 213E00000X
MO000582213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100779880AMedicaid
OK243507308Medicare ID - Type Unspecified
U20431Medicare UPIN