Provider Demographics
NPI:1851322648
Name:BARNES, NAOMI G (OD)
Entity Type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:G
Last Name:BARNES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201-B 2ND ST E
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937
Mailing Address - Country:US
Mailing Address - Phone:406-862-3346
Mailing Address - Fax:406-862-6901
Practice Address - Street 1:201-B 2ND ST E
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937
Practice Address - Country:US
Practice Address - Phone:406-862-3346
Practice Address - Fax:406-862-6901
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT537152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0482417Medicaid
MT000002882Medicare ID - Type Unspecified
MT0482417Medicaid