Provider Demographics
NPI:1063500874
Name:BARNHURST, WILLIAM R (DO)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:BARNHURST
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 S CEDAR CREST BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-7902
Mailing Address - Country:US
Mailing Address - Phone:610-435-3111
Mailing Address - Fax:610-432-5953
Practice Address - Street 1:1101 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-7902
Practice Address - Country:US
Practice Address - Phone:610-435-3111
Practice Address - Fax:610-432-5953
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS002637L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000953021Medicaid
PA000953021Medicaid
PA041923Medicare ID - Type Unspecified