Provider Demographics
NPI:1386717668
Name:BAREFOOT, JULES JACKSON III (MD)
Entity type:Individual
Prefix:
First Name:JULES
Middle Name:JACKSON
Last Name:BAREFOOT
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11804 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:KY
Mailing Address - Zip Code:40223
Mailing Address - Country:US
Mailing Address - Phone:502-386-0656
Mailing Address - Fax:502-244-5783
Practice Address - Street 1:801 W BROADWAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202
Practice Address - Country:US
Practice Address - Phone:502-386-0656
Practice Address - Fax:502-244-5783
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY246662083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C68399Medicare UPIN