MEDICARE: DR. DOUGLAS PAUL BARNEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	165309-1205	UT
2	207PE0005X	Undersea and Hyperbaric Medicine (Emergency Medicine) Physician	165309-1205	UT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DB3302	OTHER	UT	MEDICARE RR GROUP
4	P00108675	OTHER	UT	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	PRA06257	OTHER	UT	MOLINA
3	70845	OTHER	UT	PEHP
5	0101998	OTHER	UT	UHC

General Provider Information

NPI Number	:	1013081801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS PAUL BARNEY MD

Provider Business Mailing Address
First Line	:	3103 BOULDER DR
Second Line	:
City	:	LAYTON
State	:	UT
Zip	:	84040-7717
Country	:	US
Telephone Number	:	801-643-4315
Fax Number	:	801-807-7904

Provider Business Practice Location Address
First Line	:	2132 NORTH 1700 WEST
Second Line	:	SUITE 100
City	:	LAYTON
State	:	UT
Zip	:	84041-7059
Country	:	US
Telephone Number	:	801-807-7900
Fax Number	:	801-807-7904

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	02/07/2012

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Directions to “ DR. DOUGLAS PAUL BARNEY MD” Practice Location

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