Provider Demographics
NPI:1427023506
Name:BARNES, DAVID R (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:BARNES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 GUNBARREL RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-7137
Mailing Address - Country:US
Mailing Address - Phone:423-778-8582
Mailing Address - Fax:423-778-8594
Practice Address - Street 1:1755 GUNBARREL RD
Practice Address - Street 2:SUITE 301
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-7137
Practice Address - Country:US
Practice Address - Phone:423-778-8582
Practice Address - Fax:423-778-8594
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000008053174400000X
TNMD008053207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00212319BMedicaid
TN3180486Medicaid
GA00212319BMedicaid
TN3180486Medicaid
GA048DCHLMedicare ID - Type Unspecified