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General NPI Number Information
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NPI Number | 1023971215
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Entity Type | Organization
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Legal Business Name | BARNES DIRECT PRIMARY CARE LLC
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 3002 W JUNGE BLVD
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City | JOPLIN
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State | MO
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Zip | 64801-3529
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Country | US
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Telephone | 620-224-5950
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Fax |
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Provider Business Mailing Address
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Address Line | 4925 S BROADWAY AVE 1116
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City | WICHITA
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State | KS
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Zip | 67216-3716
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Country | US
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Telephone | 620-224-5950
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | BRETT ASHTON BARNES
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Credential | FNP-BC, FNP-C
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Telephone | 620-224-5950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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