Provider Demographics
NPI:1245208636
Name:BARNES, MATTHEW S (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:S
Last Name:BARNES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 S MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:ADAMSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38310-2214
Mailing Address - Country:US
Mailing Address - Phone:731-632-9100
Mailing Address - Fax:731-632-1109
Practice Address - Street 1:112 S MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:ADAMSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38310-2214
Practice Address - Country:US
Practice Address - Phone:731-632-9100
Practice Address - Fax:731-632-1109
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000001363111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3735114Medicaid
TN3679850Medicare ID - Type UnspecifiedPROVIDER NUMBER
TN3735114Medicaid
TNU68968Medicare UPIN