Provider Demographics
NPI:1740306000
Name:WILLIAM W. BARNES, III, M.D.
Entity type:Organization
Organization Name:WILLIAM W. BARNES, III, M.D.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:W
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-341-4311
Mailing Address - Street 1:525 E BLUE STARR DR
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-4483
Mailing Address - Country:US
Mailing Address - Phone:918-341-4311
Mailing Address - Fax:918-341-8189
Practice Address - Street 1:525 E BLUE STARR DR
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-4483
Practice Address - Country:US
Practice Address - Phone:918-341-4311
Practice Address - Fax:918-341-8189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK37D0473148OtherCLIA #