MEDICARE: DR. THOMAS L BARNES M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician	MA40138	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629005798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS L BARNES M.D.

Provider Business Mailing Address
First Line	:	40 LAKE CENTER DRIVE 401 ROUTE 73 NORTH
Second Line	:	SUITE 201A
City	:	MARLTON
State	:	NJ
Zip	:	08053-3425
Country	:	US
Telephone Number	:	856-355-0340
Fax Number	:	856-355-0346

Provider Business Practice Location Address
First Line	:	212 CREEK CROSSING BLVD
Second Line	:
City	:	HAINESPORT
State	:	NJ
Zip	:	08036-2766
Country	:	US
Telephone Number	:	609-267-1004
Fax Number	:	609-267-1044

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	05/07/2012

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