MEDICARE: TRAVIS V BARNHART D.C.

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	111N00000X	Chiropractor	08001268A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000090849	OTHER	IN	ANTHEM

General Provider Information

NPI Number	:	1659594950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRAVIS V BARNHART D.C.

Provider Business Mailing Address
First Line	:	1841 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-2735
Country	:	US
Telephone Number	:	317-352-1516
Fax Number	:	317-356-5178

Provider Business Practice Location Address
First Line	:	1841 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-2735
Country	:	US
Telephone Number	:	317-352-1516
Fax Number	:	317-356-5178

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

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	02/01/2008

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