Mark Joseph Barbara, MD
Individual provider Active NPI Psychiatry Physician · Edgewood, KY
NPI 1104807197 · NPPES record last updated Nov 27, 2012
Key facts
- NPI
- 1104807197
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 23911 (KY)
- Practice address
- 200 Medical Village Dr
Edgewood, KY 41017-3408 - Phone
- (859) 301-5900
- Fax
- (859) 301-5940
- NPI assigned
- Nov 8, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35053462 | OH | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Elizabeth Medical Center, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 35053462 | OH | |
| Psychiatry Physician | 2084P0800X | 23911 | KY | Yes |
Addresses
Primary practice location
200 Medical Village Dr
Edgewood, KY 41017-3408
Mailing address
PO Box 635283
St. Elizabeth Physicians
Cincinnati, OH 45263-5283
Phone (859) 344-5555
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200939960 | Medicaid | IN | |
| 0668086 | Medicaid | OH | |
| 7100059720 | Medicaid | KY |
Other providers in Edgewood, KY
- Brian Baker
- Christine A Baker
- James Douglas Baker
- Benjamin Allen Bale
- Bradley James Bankers
- David Lee Barber
- James F Bardgett Jr.
- Nina Marie Barhorst
- Maria Elaine Barnes
- Mary Ann Barnes
All providers in Edgewood, KY · Psychiatry Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.