Provider Demographics
NPI:1699432070
Name:BARNETT, COLTEN JAY
Entity type:Individual
Prefix:MR
First Name:COLTEN
Middle Name:JAY
Last Name:BARNETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 MEDICAL PKWY
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-1088
Mailing Address - Country:US
Mailing Address - Phone:918-342-0770
Mailing Address - Fax:918-342-0087
Practice Address - Street 1:3100 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-1088
Practice Address - Country:US
Practice Address - Phone:918-342-0770
Practice Address - Fax:918-342-0087
Is Sole Proprietor?:No
Enumeration Date:2021-11-20
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist