MEDICARE: DR. DAVID LEROY BARNES SR. DDS

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	122300000X	Dentist	1572 SC	SC

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	:	1811037633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID LEROY BARNES SR. DDS

Provider Business Mailing Address
First Line	:	PO BOX 547
Second Line	:	144 CATHERINE ST NORTH
City	:	ESTILL
State	:	SC
Zip	:	29918-0547
Country	:	US
Telephone Number	:	803-625-3640
Fax Number	:

Provider Business Practice Location Address
First Line	:	144 CATHERINE STREET NORTH
Second Line	:
City	:	ESTILL
State	:	SC
Zip	:	29918-0547
Country	:	US
Telephone Number	:	803-625-3640
Fax Number	:

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

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	07/08/2007

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