Healthcare Provider Details

I. General information

NPI: 1326247149
Provider Name (Legal Business Name): BARNARD PLASTIC SURGERY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 10/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 SAINT FRANCIS DR STE 310
WATERLOO IA
50702-5620
US

IV. Provider business mailing address

PO BOX 2660
WATERLOO IA
50704-2660
US

V. Phone/Fax

Practice location:
  • Phone: 319-272-8488
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK BARNARD
Title or Position: MD
Credential:
Phone: 319-233-3044