Provider Demographics
NPI:1396721676
Name:BARNHILL, MARK A (DO)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:BARNHILL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8101 BIRCHWOOD CT
Mailing Address - Street 2:SUITE N
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-2930
Mailing Address - Country:US
Mailing Address - Phone:515-471-9243
Mailing Address - Fax:515-471-9319
Practice Address - Street 1:8101 BIRCHWOOD CT
Practice Address - Street 2:SUITE N
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-2930
Practice Address - Country:US
Practice Address - Phone:515-471-9243
Practice Address - Fax:515-471-9319
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2012-05-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA01667208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1396721676Medicaid
IA0174565Medicaid
IA4174565Medicaid
IA370015258OtherRR MEDICARE
IA1396721676Medicaid
IA4174565Medicaid