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General NPI Number Information
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NPI Number | 1770640393
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Entity Type | Individual
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Provider Name | JEFFREY GEORGE BARNES D.O.
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Gender | Male
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 120 SHANNON DR
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-6684
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Country | US
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Telephone | 910-603-6064
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Fax |
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Provider Business Mailing Address
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Address Line | 120 SHANNON DR
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-6684
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Country | US
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Telephone | 910-603-6064
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 306899
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License Number State | NY
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