MEDICARE: ELIZABETH S BARNES 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	35077950	OH
2	207Q00000X	Family Medicine Physician	30863	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000197878	OTHER	OH	ANTHEM BLUE CROSS/SHIELD

General Provider Information

NPI Number	:	1629015326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH S BARNES M.D.

Provider Business Mailing Address
First Line	:	PO BOX 14883
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27415-4883
Country	:	US
Telephone Number	:	336-274-6515
Fax Number	:	336-275-0812

Provider Business Practice Location Address
First Line	:	1210 NEW GARDEN RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-2721
Country	:	US
Telephone Number	:	336-294-6190
Fax Number	:	336-294-6278

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

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	04/09/2021

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