Healthcare Provider Details

I. General information

NPI: 1366937674
Provider Name (Legal Business Name): JASON ARTHUR BRYCE BARNES DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2018
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL DR # DC00.500
COLUMBIA MO
65212-1000
US

IV. Provider business mailing address

1 HOSPITAL DR # DC00.500
COLUMBIA MO
65212-1000
US

V. Phone/Fax

Practice location:
  • Phone: 573-882-2568
  • Fax:
Mailing address:
  • Phone: 573-882-2568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberFB3136050
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2018022808
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: