Provider Demographics
NPI:1427051820
Name:BARNES, SCOTT GREY (DO)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:GREY
Last Name:BARNES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 N 12TH ST UPPR LEVEL
Mailing Address - Street 2:
Mailing Address - City:LEMOYNE
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1428
Mailing Address - Country:US
Mailing Address - Phone:717-737-5767
Mailing Address - Fax:717-737-6268
Practice Address - Street 1:50 N 12TH ST
Practice Address - Street 2:UPPER LEVEL
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043-1428
Practice Address - Country:US
Practice Address - Phone:717-737-5767
Practice Address - Fax:717-737-6268
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS003686L207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA830005774OtherPALMETO GBA-UNITED HEALTHCARE MEDICARE
PA0009766070002Medicaid
PA94868OtherCOVENTRY
PA091891OtherHIGHMARK BLUE SHIELD
PA4267938OtherAETNA
PAC29614Medicare UPIN
PW0830200001Medicare NSC
PA091891Medicare PIN