Provider Demographics
NPI:1750398517
Name:BARNHART, DOUGLAS C (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:C
Last Name:BARNHART
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 MARIO CAPECCHI DR
Mailing Address - Street 2:SUITE 2600
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84113-1103
Mailing Address - Country:US
Mailing Address - Phone:801-662-2950
Mailing Address - Fax:801-662-2980
Practice Address - Street 1:100 MARIO CAPECCHI DR
Practice Address - Street 2:SUITE 2600
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84113-1103
Practice Address - Country:US
Practice Address - Phone:801-662-2950
Practice Address - Fax:801-662-2980
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2021-10-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL23984208600000X
UT159721-12052086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009970605Medicaid
AL009946925Medicaid
AL051502441OtherBLUE CROSS
AL051502441Medicaid
AL051520462OtherBLUE CROSS
UT1750398517Medicaid
ID808118600Medicaid
MS01780854OtherMISSISSIPPI MEDICAID
AL020049268OtherRAILROAD MEDICARE
AL051520463OtherBLUE CROSS
AL051520462OtherBLUE CROSS