MEDICARE: MCKENNA MARLEY BARNETT OD

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	152W00000X	Optometrist	18004664A	IN

General Provider Information

NPI Number	:	1720912017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MCKENNA MARLEY BARNETT OD

Provider Business Mailing Address
First Line	:	2839 LAFAYETTE RD # A
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-2147
Country	:	US
Telephone Number	:	317-924-1300
Fax Number	:	855-326-4293

Provider Business Practice Location Address
First Line	:	2835 LAFAYETTE RD # A
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-2147
Country	:	US
Telephone Number	:	317-926-0283
Fax Number	:	855-326-4293

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

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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