Provider Demographics
NPI:1619095387
Name:BARNES, WILLIAM DARYL (DC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DARYL
Last Name:BARNES
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 1:4655 WILLIAM FLYNN HWY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-2243
Mailing Address - Country:US
Mailing Address - Phone:412-492-8622
Mailing Address - Fax:412-492-8623
Practice Address - Street 1:4655 WILLIAM FLYNN HWY
Practice Address - Street 2:SUITE 120
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101-2243
Practice Address - Country:US
Practice Address - Phone:412-492-8622
Practice Address - Fax:412-492-8623
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007538L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA643232Medicare UPIN
PA028756Medicare ID - Type Unspecified