Provider Demographics
NPI:1396741245
Name:BARNETT, STEVEN C (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:C
Last Name:BARNETT
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 1:12067 SPURGEON RD
Mailing Address - Street 2:
Mailing Address - City:LYNNVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47619-8015
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12067 SPURGEON RD
Practice Address - Street 2:
Practice Address - City:LYNNVILLE
Practice Address - State:IN
Practice Address - Zip Code:47619-8015
Practice Address - Country:US
Practice Address - Phone:812-922-5568
Practice Address - Fax:812-922-5560
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2022-05-23
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-23
Provider Licenses
StateLicense IDTaxonomies
IN01037697207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100117290Medicaid
IN100117290Medicaid
IN250470VMedicare PIN
IN100117290Medicaid
IN250470OtherMEDICARE GROUP
INE32492Medicare UPIN