Provider Demographics
NPI:1528075694
Name:BARRETT, JOHN LLOYD (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LLOYD
Last Name:BARRETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SEAN
Other - Middle Name:LLOYD
Other - Last Name:BARRETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:114 GALLERY DR
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2690
Mailing Address - Country:US
Mailing Address - Phone:412-831-8089
Mailing Address - Fax:412-831-2955
Practice Address - Street 1:114 GALLERY DR
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2690
Practice Address - Country:US
Practice Address - Phone:412-831-8089
Practice Address - Fax:412-831-2955
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032030E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00166131700015Medicaid
PA0010805700006Medicaid
PA90550OtherHEALTH AMERICA
PA737678OtherAETNA
PA080133400OtherRAILROAD MEDICARE
PA0016613170003Medicaid
PA003230OtherHIGHMARK BC/BS
PA203680OtherUPMC
PA0016613170002Medicaid
PA203680OtherUPMC
PA00166131700015Medicaid