Provider Demographics
NPI:1457457905
Name:BARNETT, MERLE STANLEY (DC)
Entity Type:Individual
Prefix:
First Name:MERLE
Middle Name:STANLEY
Last Name:BARNETT
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 1:2908 BROWNSBORO RD STE 210
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-3506
Mailing Address - Country:US
Mailing Address - Phone:502-895-9080
Mailing Address - Fax:502-895-9080
Practice Address - Street 1:2908 BROWNSBORO RD STE 210
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-3506
Practice Address - Country:US
Practice Address - Phone:502-895-9080
Practice Address - Fax:502-895-9080
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4085111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY4400387OtherUNITED#
KY000000043079OtherANTHEM
KY620 106OtherACN ID
KY620 106OtherACN ID
KYU55488Medicare UPIN