Healthcare Provider Details

I. General information

NPI: 1184621989
Provider Name (Legal Business Name): ROBERT D. BARNES III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 05/23/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 N 1ST AVE STE E
EVANSVILLE IN
47710-3326
US

IV. Provider business mailing address

3838 N 1ST AVE # E
EVANSVILLE IN
47710-3326
US

V. Phone/Fax

Practice location:
  • Phone: 812-425-3362
  • Fax: 812-428-8412
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01033267A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: