Provider Demographics
NPI:1306832811
Name:GARNER, BARRY MATT (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:MATT
Last Name:GARNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MATT
Other - Middle Name:
Other - Last Name:GARNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1000 EAST MATTHEWS SUITE E
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4344
Mailing Address - Country:US
Mailing Address - Phone:870-336-0472
Mailing Address - Fax:870-336-5320
Practice Address - Street 1:1000 EAST MATTHEWS SUITE E
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4344
Practice Address - Country:US
Practice Address - Phone:870-336-0472
Practice Address - Fax:870-336-5320
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC7694207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR119192001Medicaid
AR119192001Medicaid
ARE78258Medicare UPIN