Healthcare Provider Details

I. General information

NPI: 1912947060
Provider Name (Legal Business Name): BARRY A. WARNER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 05/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 KNOLLWOOD DR FOUR MEDICAL PARK
MOBILE AL
36693-7003
US

IV. Provider business mailing address

PO BOX 40480
MOBILE AL
36640-0480
US

V. Phone/Fax

Practice location:
  • Phone: 251-660-5787
  • Fax: 251-660-5792
Mailing address:
  • Phone: 251-660-5787
  • Fax: 251-660-5792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberDO-166
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: