Basic Information
| Provider Information | |||||||||
| NPI: | 1265451595 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARB | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | ELY | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5334 MEADOW LANE CT | ||||||||
| Address2: | |||||||||
| City: | SHEFFIELD VILLAGE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440351469 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4409348921 | ||||||||
| FaxNumber: | 4409348938 | ||||||||
| Practice Location | |||||||||
| Address1: | 5172 LEAVITT RD | ||||||||
| Address2: | |||||||||
| City: | LORAIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402827420 | ||||||||
| FaxNumber: | 4402828614 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2006 | ||||||||
| LastUpdateDate: | 12/30/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 34.002015 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.