Provider Demographics
NPI:1346242062
Name:BARNES, STEVEN SHAWN (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:SHAWN
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 1:2901 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-0308
Mailing Address - Country:US
Mailing Address - Phone:712-328-8410
Mailing Address - Fax:712-328-8733
Practice Address - Street 1:2901 N BROADWAY
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-0308
Practice Address - Country:US
Practice Address - Phone:712-328-8410
Practice Address - Fax:712-328-8733
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06189111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA48289OtherBLUE CROSS BLUE SHIELD
IA1184101Medicaid
IA48289OtherBLUE CROSS BLUE SHIELD
IAI6567Medicare PIN