Provider Demographics
NPI:1265866438
Name:BARNER, ROBERT WAYNE
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WAYNE
Last Name:BARNER
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:WAYNE
Other - Last Name:BARNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:500 SUN VALLEY DR
Mailing Address - Street 2:A3
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-1482
Mailing Address - Country:US
Mailing Address - Phone:678-613-4748
Mailing Address - Fax:
Practice Address - Street 1:500 SUN VALLEY DR
Practice Address - Street 2:A3
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1482
Practice Address - Country:US
Practice Address - Phone:678-613-4748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-23
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2253111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation