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General NPI Number Information
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NPI Number | 1750610887
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Entity Type | Organization
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Legal Business Name | BARNES EYECARE INC
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Dates
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Enumeration Date | 12/21/2009
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Last Update Date | 12/21/2009
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Provider Practice Location Address
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Address Line | 2801 W STATE ROUTE 18
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City | TIFFIN
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State | OH
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Zip | 44883-8950
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Country | US
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Telephone | 419-443-1950
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Fax | 419-443-1969
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Provider Business Mailing Address
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Address Line | 15631 COUNTY HIGHWAY 109
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City | UPPER SANDUSKY
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State | OH
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Zip | 43351-9435
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. KIMBERLEY BARNES
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Credential | O.D.
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Telephone | 614-205-7955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4849/T1714
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License Number State | OH
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