Healthcare Provider Details

I. General information

NPI: 1134156573
Provider Name (Legal Business Name): DONALD A. BARNHORST JR. MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 07/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6269 BEACH BLVD SUITE 4
JACKSONVILLE FL
32216
US

IV. Provider business mailing address

6269 BEACH BLVD SUITE 4
JACKSONVILLE FL
32216-2768
US

V. Phone/Fax

Practice location:
  • Phone: 904-722-3937
  • Fax: 904-722-3938
Mailing address:
  • Phone: 904-722-3937
  • Fax: 904-722-3938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License NumberME78488
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME 78488
License Number StateFL

VIII. Authorized Official

Name: DR. DONALD A BARNHORST JR.
Title or Position: OPHTHALMOLOGIST
Credential: M.D.
Phone: 904-722-3937