Provider Demographics
NPI:1811669922
Name:MICHAEL A BARNETT
Entity type:Organization
Organization Name:MICHAEL A BARNETT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:502-671-0606
Mailing Address - Street 1:9200 TAYLORSVILLE RD STE 111
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-1786
Mailing Address - Country:US
Mailing Address - Phone:502-671-0606
Mailing Address - Fax:
Practice Address - Street 1:9200 TAYLORSVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-1786
Practice Address - Country:US
Practice Address - Phone:507-671-0606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-28
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment