Provider Demographics
NPI:1326100603
Name:BARNEY, MICHAEL WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WAYNE
Last Name:BARNEY
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:PO BOX 36853
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-6853
Mailing Address - Country:US
Mailing Address - Phone:702-644-3333
Mailing Address - Fax:702-644-3336
Practice Address - Street 1:2425 N LAMB BLVD
Practice Address - Street 2:STE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89115-5420
Practice Address - Country:US
Practice Address - Phone:702-644-9155
Practice Address - Fax:702-644-1255
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB624111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV36571Medicare ID - Type UnspecifiedCHIROPRACTOR
NVU90818Medicare UPIN