MEDICARE: MR. ROBERT E. BARNETT M.D.

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	35043151	OH
2	208D00000X	General Practice Physician	35-043151	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	03142	OTHER	OH	PHC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000000338203	OTHER	OH	ANTHEM
4	18-30177	OTHER	OH	UHC
5	P00158156	OTHER	OH	RRMC
6	4468179	OTHER	OH	AETNA

General Provider Information

NPI Number	:	1033102918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT E. BARNETT M.D.

Provider Business Mailing Address
First Line	:	1105 RALSTON AVE
Second Line	:
City	:	DEFIANCE
State	:	OH
Zip	:	43512-1336
Country	:	US
Telephone Number	:	419-782-3111
Fax Number	:	419-782-3118

Provider Business Practice Location Address
First Line	:	1105 RALSTON AVE
Second Line	:
City	:	DEFIANCE
State	:	OH
Zip	:	43512-1336
Country	:	US
Telephone Number	:	419-782-3111
Fax Number	:	419-782-3118

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

Provider Enumeration Date	:	08/26/2005
Last Update Date	:	04/25/2012

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