MEDICARE: MADGE L BARNES 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	K6810	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01398099	OTHER	TX	RAILROAD MEDICARE

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	8CT555	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1679526875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADGE L BARNES MD

Provider Business Mailing Address
First Line	:	2950 W CAMP WISDOM RD STE 100
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-4461
Country	:	US
Telephone Number	:	972-352-2937
Fax Number	:	972-352-2996

Provider Business Practice Location Address
First Line	:	2950 W CAMP WISDOM RD STE 100
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-4461
Country	:	US
Telephone Number	:	972-352-2937
Fax Number	:	972-352-2996

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

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	04/24/2018

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Directions to “ MADGE L BARNES MD” Practice Location

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