Provider Demographics
NPI:1720028038
Name:BARNSTUBLE, BRENT BRIAN (MD)
Entity Type:Individual
Prefix:MR
First Name:BRENT
Middle Name:BRIAN
Last Name:BARNSTUBLE
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 1:400 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:MN
Mailing Address - Zip Code:56267-1408
Mailing Address - Country:US
Mailing Address - Phone:320-589-7648
Mailing Address - Fax:
Practice Address - Street 1:400 E 1ST ST
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:MN
Practice Address - Zip Code:56267-1408
Practice Address - Country:US
Practice Address - Phone:320-589-7648
Practice Address - Fax:320-208-7810
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE23391207Q00000X
ND11867207Q00000X
MN54348207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine