Provider Demographics
NPI:1083346407
Name:BARNES, RICHARD TONY
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:TONY
Last Name:BARNES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 OUTER LOOP
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40214-5544
Mailing Address - Country:US
Mailing Address - Phone:502-361-8232
Mailing Address - Fax:502-361-8840
Practice Address - Street 1:175 OUTER LOOP
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40214-5544
Practice Address - Country:US
Practice Address - Phone:502-361-8232
Practice Address - Fax:502-361-8840
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY111471156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician