Provider Demographics
NPI:1700976230
Name:BARNEY, DEBORA (MD)
Entity Type:Individual
Prefix:
First Name:DEBORA
Middle Name:
Last Name:BARNEY
Suffix:
Gender:F
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:PO BOX 370053
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89137-0053
Mailing Address - Country:US
Mailing Address - Phone:702-242-0485
Mailing Address - Fax:702-242-0360
Practice Address - Street 1:6284 S. RAINBOW BLVD
Practice Address - Street 2:#110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118
Practice Address - Country:US
Practice Address - Phone:702-242-0485
Practice Address - Fax:702-242-0360
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMD69572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVMD6957Medicare ID - Type Unspecified
F97696Medicare UPIN