Provider Demographics
NPI:1427643311
Name:BARTON, KASEY (DPH)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:
Last Name:BARTON
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 STABLEGATE
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-5159
Mailing Address - Country:US
Mailing Address - Phone:580-302-0334
Mailing Address - Fax:
Practice Address - Street 1:1349 E EAGLE RD
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-9208
Practice Address - Country:US
Practice Address - Phone:580-772-2712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12537183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist