Provider Demographics
NPI:1588686687
Name:SIEBRING, BARTON G (MD)
Entity type:Individual
Prefix:
First Name:BARTON
Middle Name:G
Last Name:SIEBRING
Suffix:
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 1:2871 GREENSBORO RD
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112
Mailing Address - Country:US
Mailing Address - Phone:276-638-2273
Mailing Address - Fax:276-638-2223
Practice Address - Street 1:DR JON'S URGENT CARE CENTER
Practice Address - Street 2:2871 GREENSBORO RD
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112
Practice Address - Country:US
Practice Address - Phone:276-638-2273
Practice Address - Fax:276-638-2223
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI32617207P00000X, 207Q00000X
VA0101252639207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31758200Medicaid
683750677Medicare PIN
WI31758200Medicaid