Provider Demographics
NPI:1669068821
Name:BARNES, STEPHEN DWAYNE (DOCTOR OF PHARMACY)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:DWAYNE
Last Name:BARNES
Suffix:
Gender:M
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13218 LOMA LINDA DR
Mailing Address - Street 2:
Mailing Address - City:GRAVETTE
Mailing Address - State:AR
Mailing Address - Zip Code:72736-8774
Mailing Address - Country:US
Mailing Address - Phone:479-659-2120
Mailing Address - Fax:
Practice Address - Street 1:1007 JONES RD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0705
Practice Address - Country:US
Practice Address - Phone:479-361-1950
Practice Address - Fax:479-361-1908
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD08540183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist