1386685683 NPI number — TERRY P. BARNES, MS, P.C.

Table of content: (NPI 1386685683)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386685683 NPI number — TERRY P. BARNES, MS, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TERRY P. BARNES, MS, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1386685683
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/13/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 436
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HYDE PARK
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84318-0436
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
435-753-0272
Provider Business Mailing Address Fax Number:
435-753-2252

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9 W CENTER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HYDE PARK
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84318-3201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-753-0272
Provider Business Practice Location Address Fax Number:
435-753-2252
Provider Enumeration Date:
06/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BARNES
Authorized Official First Name:
TERRY
Authorized Official Middle Name:
P.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
435-753-0272

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X , with the licence number:  116331-3902 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 16739 . This is a "DMBA" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 23380 . This is a "PEHP" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 46170597802001 . This is a "BCBS OF UT" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 107007407101 . This is a "SELECTHEALTH" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 461705978 . This is a "FIRSTHEALTH" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".




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