Healthcare Provider Details

I. General information

NPI: 1306200290
Provider Name (Legal Business Name): RYAN THOMAS BARNES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2016
Last Update Date: 09/18/2023
Certification Date: 09/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 DOOLEY ST SE
CLEVELAND TN
37311-6220
US

IV. Provider business mailing address

1301 RIVERFRONT PKWY STE 209
CHATTANOOGA TN
37402-3312
US

V. Phone/Fax

Practice location:
  • Phone: 423-728-7020
  • Fax: 423-479-6130
Mailing address:
  • Phone: 423-634-3124
  • Fax: 423-634-3186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2019-01429
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2019-01429
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number61034
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: