MEDICARE: DR. MITCHELL F BARNEY 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	174400000X	Specialist	171974-1205	UT
2	207V00000X	Obstetrics & Gynecology Physician	171974-1205	UT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000055148	OTHER	UT	MEDICARE PAYER ID

General Provider Information

NPI Number	:	1912986142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHELL F BARNEY MD

Provider Business Mailing Address
First Line	:	3570 W 9000 S
Second Line	:	#210
City	:	WEST JORDAN
State	:	UT
Zip	:	84088-8876
Country	:	US
Telephone Number	:	801-569-2626
Fax Number	:	801-569-5333

Provider Business Practice Location Address
First Line	:	3570 W 9000 S
Second Line	:	#210
City	:	WEST JORDAN
State	:	UT
Zip	:	84088-8876
Country	:	US
Telephone Number	:	801-569-2626
Fax Number	:	801-569-5333

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

Provider Enumeration Date	:	01/16/2006
Last Update Date	:	09/24/2018

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Directions to “ DR. MITCHELL F BARNEY MD” Practice Location

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