Provider Demographics
NPI:1790788164
Name:BARNES, RODNEY (MD)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:
Last Name:BARNES
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 1:805 NEW HAMPSHIRE ST STE C
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2774
Mailing Address - Country:US
Mailing Address - Phone:785-856-0452
Mailing Address - Fax:785-749-3621
Practice Address - Street 1:1709 W 7TH ST
Practice Address - Street 2:
Practice Address - City:CHANUTE
Practice Address - State:KS
Practice Address - Zip Code:66720-2505
Practice Address - Country:US
Practice Address - Phone:620-431-0023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0416457207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1790788164OtherNPI
KS100085970CMedicaid
KS103353Medicare PIN