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JODY A BARHAM APN
Psychiatric/Mental Health >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1992081491
Individual Registrant: JODY A BARHAM APN
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
1205 E 35TH ST TEXARKANA, AR 71854-2746 US
Tel: 870-216-0080 Fax: 870-216-0096
Tel: 870-216-0080 Fax: 870-216-0096
Contact information for business:
4323 JEFFERSON AVE TEXARKANA, AR 71854-1515 US
Tel: 870-773-0700 Fax: 870-773-0705
Tel: 870-773-0700 Fax: 870-773-0705
Registration Information:
NPI: 1992081491
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Psychiatric/Mental Health | AR | A03610 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| LICENSE | A003610 | AR | 01 |
