Provider Demographics
NPI:1033160114
Name:BARNES, JOHN G (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:G
Last Name:BARNES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15769 WC MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-7327
Mailing Address - Country:US
Mailing Address - Phone:804-419-9702
Mailing Address - Fax:804-378-9143
Practice Address - Street 1:15769 WC MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-7327
Practice Address - Country:US
Practice Address - Phone:804-419-9702
Practice Address - Fax:804-378-9143
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101036995207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA540883363OtherPHCS
VA0100405OtherUNTIED HEALTHCARE
VA5633915Medicaid
VA10524OtherCIGNA
VA540883363OtherCHAMPUS-TRICARE
VA856744OtherMAMSI
VA540883363OtherGREAT WEST HEALTCARE
VA540883363OtherPREFERRED CARE
VA10002698OtherOPTIMA
VA116040OtherANTHEM
VA539779OtherAETNA
VA540883363OtherFIRST HEALTH/CCN
VA540883363OtherVIRGINIA HEALTH NETWORK
VA82513OtherSOUTHERN HEALTH
VAB09169Medicare UPIN
VA016343V28Medicare PIN
VA016210V26Medicare PIN
VA856744OtherMAMSI
VA5633915Medicaid