Provider Demographics
NPI:1770662330
Name:BARNES, JOHN L (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:L
Last Name:BARNES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:319 WEST HARRIS AVENUE
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903-6338
Mailing Address - Country:US
Mailing Address - Phone:325-658-8595
Mailing Address - Fax:325-658-5408
Practice Address - Street 1:319 WEST HARRIS AVENUE
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-6338
Practice Address - Country:US
Practice Address - Phone:325-658-8595
Practice Address - Fax:325-658-5408
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXD2353207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110276601Medicaid
TXK554OtherBCBS TX
TXK554OtherBCBS TX