Provider Demographics
NPI:1841693660
Name:BARNEY MEDICAL SPECIALIST LIMITED
Entity type:Organization
Organization Name:BARNEY MEDICAL SPECIALIST LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:H
Authorized Official - Last Name:BARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-880-1558
Mailing Address - Street 1:2810 W CHARLESTON BLVD
Mailing Address - Street 2:SUITE E-47
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1921
Mailing Address - Country:US
Mailing Address - Phone:702-880-1558
Mailing Address - Fax:
Practice Address - Street 1:2810 W CHARLESTON BLVD
Practice Address - Street 2:SUITE E-47
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1921
Practice Address - Country:US
Practice Address - Phone:702-880-1558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6980207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty