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General NPI Number Information
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NPI Number | 1952110496
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Entity Type | Individual
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Provider Name | JUSTIN RYNE BARNETT MD
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Gender | Male
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 07/12/2025
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Provider Practice Location Address
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Address Line | 460 N WHITE RIVER PKWY WEST DR APT 108
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City | INDIANAPOLIS
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State | IN
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Zip | 46222-4590
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Country | US
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Telephone | 405-464-5069
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Fax |
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Provider Business Mailing Address
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Address Line | 101 E WOOD ST
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City | SPARTANBURG
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State | SC
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Zip | 29303-3040
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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 |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | LL95135
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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