MEDICARE: MR. PHILIP CHARLES BARNARD D.C.

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	111N00000X	Chiropractor	4946A	AZ

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	:	1891757852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PHILIP CHARLES BARNARD D.C.

Provider Business Mailing Address
First Line	:	2440 HWY 95
Second Line	:
City	:	BULLHEAD CITY
State	:	AZ
Zip	:	86442-7323
Country	:	US
Telephone Number	:	928-704-2225
Fax Number	:	928-704-0402

Provider Business Practice Location Address
First Line	:	2440 HWY 95
Second Line	:
City	:	BULLHEAD CITY
State	:	AZ
Zip	:	86442-7323
Country	:	US
Telephone Number	:	928-704-2225
Fax Number	:	928-704-0402

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

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	06/06/2012

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