Provider Demographics
NPI:1275508673
Name:BARNES, LLOYD R (MD)
Entity Type:Individual
Prefix:
First Name:LLOYD
Middle Name:R
Last Name:BARNES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 TUSCULUM BLVD
Mailing Address - Street 2:STE 1800
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4286
Mailing Address - Country:US
Mailing Address - Phone:423-787-7060
Mailing Address - Fax:423-787-7063
Practice Address - Street 1:1410 TUSCULUM BLVD
Practice Address - Street 2:STE 1800
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4286
Practice Address - Country:US
Practice Address - Phone:423-787-7060
Practice Address - Fax:423-787-7063
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-20
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000007477174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6200948222OtherEFIN
B02690Medicare UPIN
TN6200948222OtherEFIN