Provider Demographics
NPI:1871592600
Name:BARTON, JEROME (MD)
Entity type:Individual
Prefix:
First Name:JEROME
Middle Name:
Last Name:BARTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 MAIN AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-1080
Mailing Address - Country:US
Mailing Address - Phone:203-845-2200
Mailing Address - Fax:203-847-1940
Practice Address - Street 1:761 MAIN AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-1080
Practice Address - Country:US
Practice Address - Phone:203-845-2200
Practice Address - Fax:203-847-1940
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT011191207X00000X, 207XX0005X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
010011191CT01OtherANTHEM BCBS
020169OtherHEALTHNET
ZS417OtherOXFORD
CT10441914OtherCAQH
4287774OtherAETNA
7281673OtherCIGNA
1217475OtherUNITED HEALTH CARE
111910OtherCONNECTICARE
010011191CT01OtherANTHEM BCBS
111910OtherCONNECTICARE
CTC00521Medicare PIN