1265484109 NPI number — DR. ROBERT B BARNES DO

Table of content: DR. ROBERT B BARNES DO (NPI 1265484109)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265484109 NPI number — DR. ROBERT B BARNES DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARNES
Provider First Name:
ROBERT
Provider Middle Name:
B
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265484109
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/12/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1605 N CEDAR CREST BLVD
Provider Second Line Business Mailing Address:
SUITE 110B
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18104-2351
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-973-1410
Provider Business Mailing Address Fax Number:
610-973-1449

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
723 CHESTNUT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EMMAUS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18049-2017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-967-4830
Provider Business Practice Location Address Fax Number:
484-403-4017
Provider Enumeration Date:
05/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  OS011102L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000146356 . This is a "UNISON AB" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P00155528 . This is a "PALMETTO RR" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50022271 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0018507440001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1314436 . This is a "HIGHMARK PA BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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