Provider Demographics
NPI:1134119357
Name:BARNETT, ROBERT KYLE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:KYLE
Last Name:BARNETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:R
Other - Middle Name:KYLE
Other - Last Name:BARNETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1393 E SEGO LILY DR
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-4350
Mailing Address - Country:US
Mailing Address - Phone:801-619-9000
Mailing Address - Fax:801-619-9001
Practice Address - Street 1:1393 E SEGO LILY DR
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84092-4350
Practice Address - Country:US
Practice Address - Phone:801-619-9000
Practice Address - Fax:801-619-9001
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT178580-1205207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1985821Medicaid
LAF75879Medicare UPIN
LA5U204Medicare ID - Type Unspecified