Healthcare Provider Details

I. General information

NPI: 1336334952
Provider Name (Legal Business Name): BARNES MEDICAL CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 10/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 S ASH ST
NEVADA MO
64772-3223
US

IV. Provider business mailing address

RR 6 BOX 110-9
NEVADA MO
64772-9432
US

V. Phone/Fax

Practice location:
  • Phone: 417-667-3355
  • Fax: 417-448-3796
Mailing address:
  • Phone: 417-549-6858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2004020462
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2004020462
License Number StateMO

VIII. Authorized Official

Name: DANIEL ELDON BARNES
Title or Position: OWNER
Credential: M.D.
Phone: 417-549-6858