Provider Demographics
NPI:1407840333
Name:RICHARD L. BARNES, O.D., P.A.
Entity Type:Organization
Organization Name:RICHARD L. BARNES, O.D., P.A.
Other - Org Name:VISIONCARE ARKANSAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:501-450-9191
Mailing Address - Street 1:1400 OLD MORRILTON HWY
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-3512
Mailing Address - Country:US
Mailing Address - Phone:501-450-9191
Mailing Address - Fax:501-450-9922
Practice Address - Street 1:1400 OLD MORRILTON HWY
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-3512
Practice Address - Country:US
Practice Address - Phone:501-450-9191
Practice Address - Fax:501-450-9922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2335152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR137032722Medicaid
ARCI2997Medicare PIN
AR5B972Medicare PIN
AR137032722Medicaid