Provider Demographics
NPI:1609605070
Name:BARCLAY, SHAWN
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:BARCLAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1866 GANYARD RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-6120
Mailing Address - Country:US
Mailing Address - Phone:330-245-9855
Mailing Address - Fax:
Practice Address - Street 1:1866 GANYARD RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-6120
Practice Address - Country:US
Practice Address - Phone:330-245-9855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No376J00000XNursing Service Related ProvidersHomemaker