Provider Demographics
NPI:1972616910
Name:BARRETT, WILLIAM EMMETT (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EMMETT
Last Name:BARRETT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5673 147TH ST N
Mailing Address - Street 2:PO 457
Mailing Address - City:HUGO
Mailing Address - State:MN
Mailing Address - Zip Code:55038-9302
Mailing Address - Country:US
Mailing Address - Phone:651-429-9010
Mailing Address - Fax:651-429-2574
Practice Address - Street 1:5673 147TH ST N
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:MN
Practice Address - Zip Code:55038-9302
Practice Address - Country:US
Practice Address - Phone:651-429-9010
Practice Address - Fax:651-429-2574
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNDC1502111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN44-55655OtherMEDICA
MN350002579OtherRAILROAD MEDICARE
MN0N355BAOtherBLUECROSS/BLUE SHIELD
MN040227300Medicaid
MN0N355BAOtherBLUECROSS/BLUE SHIELD