MEDICARE: JOHN BARNETT PA-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	363A00000X	Physician Assistant	0067	SD
2	363AM0700X	Medical Physician Assistant	0067	SD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00294626	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952339343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN BARNETT PA-C

Provider Business Mailing Address
First Line	:	PO BOX 86430
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57118-6430
Country	:	US
Telephone Number	:	605-322-4900
Fax Number	:	605-322-4910

Provider Business Practice Location Address
First Line	:	740 S HILL ST
Second Line	:
City	:	SALEM
State	:	SD
Zip	:	57058-8760
Country	:	US
Telephone Number	:	605-425-2855
Fax Number	:

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	04/15/2010

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Directions to “ JOHN BARNETT PA-C” Practice Location

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