Provider Demographics
NPI:1952303521
Name:BARNES, FREDERICK J (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:J
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 1:447 OFFICE PLAZA
Mailing Address - Street 2:SUITE C
Mailing Address - City:E. STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-8190
Mailing Address - Country:US
Mailing Address - Phone:570-421-7020
Mailing Address - Fax:570-421-7091
Practice Address - Street 1:600 PLAZA CT
Practice Address - Street 2:SUITE C
Practice Address - City:E STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-8263
Practice Address - Country:US
Practice Address - Phone:570-421-7020
Practice Address - Fax:570-421-7091
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD046968L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABA 719575OtherPENNSYLVANIA BLUE SHIELD
PABA71575Medicare ID - Type Unspecified
PAF25783Medicare UPIN