Provider Demographics
NPI:1972898146
Name:MEDLIN, BARBARA CASEY
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:CASEY
Last Name:MEDLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28541-0250
Mailing Address - Country:US
Mailing Address - Phone:910-347-5185
Mailing Address - Fax:910-347-9298
Practice Address - Street 1:714 NEW BRIDGE ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-5435
Practice Address - Country:US
Practice Address - Phone:910-347-5185
Practice Address - Fax:910-347-9298
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC77000020Medicaid
NC0348010001Medicare NSC