Provider Demographics
NPI:1518026749
Name:BARNETT, RICHARD DOYLE (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DOYLE
Last Name:BARNETT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-1058
Mailing Address - Country:US
Mailing Address - Phone:606-248-7505
Mailing Address - Fax:606-248-1700
Practice Address - Street 1:106 S 10TH ST
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-1058
Practice Address - Country:US
Practice Address - Phone:606-248-7505
Practice Address - Fax:606-248-1700
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY65531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60065539Medicaid