Healthcare Provider Details

I. General information

NPI: 1265991970
Provider Name (Legal Business Name): KENNETH BARNHART
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2019
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2027 LEBANON CHURCH RD FL 1
WEST MIFFLIN PA
15122-2461
US

IV. Provider business mailing address

2 ALLEGHENY CTR STE 530
PITTSBURGH PA
15212-5404
US

V. Phone/Fax

Practice location:
  • Phone: 412-469-1660
  • Fax: 412-469-8972
Mailing address:
  • Phone: 412-330-4461
  • Fax: 412-330-5844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberOA007646
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: