Provider Demographics
NPI:1134655194
Name:BARNES, EMILIE CAROLINE (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILIE
Middle Name:CAROLINE
Last Name:BARNES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EMILIE
Other - Middle Name:CAROLINE
Other - Last Name:REISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-2101
Mailing Address - Fax:614-293-9155
Practice Address - Street 1:1581 DODD DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1257
Practice Address - Country:US
Practice Address - Phone:614-293-2101
Practice Address - Fax:614-293-9155
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH351453532086S0102X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1134655194Medicaid