Provider Demographics
NPI:1407975113
Name:BARNHART, JOHN W (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:BARNHART
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4620 MAHONING AVE NW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-1419
Mailing Address - Country:US
Mailing Address - Phone:330-847-9093
Mailing Address - Fax:330-847-2225
Practice Address - Street 1:4620 MAHONING AVE NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-1419
Practice Address - Country:US
Practice Address - Phone:330-847-9093
Practice Address - Fax:330-847-2225
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4265152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0141868Medicaid
OH0722052Medicare ID - Type Unspecified
OHU33773Medicare UPIN