Provider Demographics
NPI:1104857507
Name:BARNETT, MICHAEL D JR (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:BARNETT
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2350 MIAMI VALLEY DR
Mailing Address - Street 2:STE 320
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4778
Mailing Address - Country:US
Mailing Address - Phone:937-312-1661
Mailing Address - Fax:937-312-1701
Practice Address - Street 1:2350 MIAMI VALLEY DR
Practice Address - Street 2:STE 320
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4778
Practice Address - Country:US
Practice Address - Phone:937-312-1661
Practice Address - Fax:937-312-1701
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2015-06-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35087371207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2679230Medicaid
OHH275741Medicare PIN
4189221Medicare PIN
I35891Medicare UPIN