Provider Demographics
NPI:1861447138
Name:BARNHORST, DONALD ANTHONY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ANTHONY
Last Name:BARNHORST
Suffix:JR
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 1:6269 BEACH BLVD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-2705
Mailing Address - Country:US
Mailing Address - Phone:904-722-3937
Mailing Address - Fax:904-722-3938
Practice Address - Street 1:6269 BEACH BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-2705
Practice Address - Country:US
Practice Address - Phone:904-722-3937
Practice Address - Fax:904-722-3938
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 78488207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL49457Medicare ID - Type Unspecified
FL649709Medicare UPIN