Provider Demographics
NPI:1295759371
Name:BARNETT, KEVIN MICHAEL (NMD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:MICHAEL
Last Name:BARNETT
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 W CHANDLER BLVD
Mailing Address - Street 2:SUITE A2
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-4907
Mailing Address - Country:US
Mailing Address - Phone:480-782-7522
Mailing Address - Fax:480-782-7522
Practice Address - Street 1:325 N ALMA SCHOOL RD
Practice Address - Street 2:SUITE 5
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4379
Practice Address - Country:US
Practice Address - Phone:480-782-7522
Practice Address - Fax:480-782-7522
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ09-1116175F00000X, 175F00000X
IAA06006111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
44994Medicare PIN
U65799Medicare UPIN