Provider Demographics
NPI:1184709834
Name:BARNES, BARRETT HENLEY (MD)
Entity type:Individual
Prefix:DR
First Name:BARRETT
Middle Name:HENLEY
Last Name:BARNES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BARRETT
Other - Middle Name:HENELY
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1204 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-2824
Practice Address - Country:US
Practice Address - Phone:434-924-0123
Practice Address - Fax:434-243-3300
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012411772080P0206X, 2080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO96055049Medicaid
CO96055049Medicaid
I42770Medicare UPIN