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General NPI Number Information
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NPI Number | 1598758591
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Entity Type | Individual
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Provider Name | KELLIE ELIZABETH BARNES DDS
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Gender | Female
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Dates
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Enumeration Date | 08/24/2005
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Last Update Date | 01/07/2021
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Provider Practice Location Address
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Address Line | 2646 E JOYCE BLVD STE 1
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-4435
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Country | US
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Telephone | 479-443-8009
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Fax | 479-443-4450
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Provider Business Mailing Address
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Address Line | 2646 E JOYCE BLVD STE 1
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-4435
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Country | US
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Telephone | 479-443-8009
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Fax | 479-443-4450
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5660
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | AR3678
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License Number State | AR
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