Provider Demographics
NPI:1326195264
Name:PICKAWAY PEDIATRIC AND FAMILY CARE, INC.
Entity type:Organization
Organization Name:PICKAWAY PEDIATRIC AND FAMILY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAYNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-420-8060
Mailing Address - Street 1:600 N PICKAWAY ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-2409
Mailing Address - Country:US
Mailing Address - Phone:740-420-8048
Mailing Address - Fax:
Practice Address - Street 1:600 N PICKAWAY ST
Practice Address - Street 2:SUITE 300
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-2409
Practice Address - Country:US
Practice Address - Phone:740-420-8048
Practice Address - Fax:740-420-8060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2201718Medicaid
OH9329511Medicare PIN