Healthcare Provider Details

I. General information

NPI: 1851332407
Provider Name (Legal Business Name): RICHARD RAY BARNES JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RICHARD R BARNES JR.

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 02/03/2021
Certification Date: 02/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 TYSON AVE
PARIS TN
38242-4544
US

IV. Provider business mailing address

PO BOX 187
LAND O LAKES FL
34639-0187
US

V. Phone/Fax

Practice location:
  • Phone: 731-642-1220
  • Fax: 731-642-1220
Mailing address:
  • Phone: 813-625-6618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number321929
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number321929
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME69285
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number48412
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01075955A
License Number StateIN
# 6
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number51898
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: