Provider Demographics
NPI:1518062462
Name:BARNETT, HUGH GLENN II (MD)
Entity Type:Individual
Prefix:DR
First Name:HUGH
Middle Name:GLENN
Last Name:BARNETT
Suffix:II
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:PO BOX 1000
Mailing Address - Street 2:DEPT 575
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:731-423-1267
Mailing Address - Fax:731-424-2550
Practice Address - Street 1:700 W FOREST AVE STE 200
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-3940
Practice Address - Country:US
Practice Address - Phone:731-423-1267
Practice Address - Fax:731-424-2550
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD09765207T00000X
TN97652084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0702090003OtherPALMETTO GBA DME
TN6929OtherMEMPHIS MANAGED CARE
TN0050196OtherBCBST
TN3167123Medicaid
TN0702090003OtherPALMETTO GBA DME
TN406141046Medicare PIN
TN3167123Medicare PIN