MEDICARE: MR. BILLY BARNHART

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	133NN1002X	Nutrition Education Nutritionist

General Provider Information

NPI Number	:	1265202964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BILLY BARNHART

Provider Business Mailing Address
First Line	:	70 S VAL VISTA DR # A3-424
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85296-1374
Country	:	US
Telephone Number	:	480-742-5940
Fax Number	:

Provider Business Practice Location Address
First Line	:	184 S PORTLAND AVE
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85296-2160
Country	:	US
Telephone Number	:	480-742-5940
Fax Number	:

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

Provider Enumeration Date	:	01/03/2024
Last Update Date	:	01/03/2024

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Directions to “ MR. BILLY BARNHART ” Practice Location

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