Provider Demographics
NPI:1912986142
Name:BARNEY, MITCHELL F (MD)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:F
Last Name:BARNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3570 W 9000 S
Mailing Address - Street 2:#210
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-8876
Mailing Address - Country:US
Mailing Address - Phone:801-569-2626
Mailing Address - Fax:801-569-5333
Practice Address - Street 1:3570 W 9000 S
Practice Address - Street 2:#210
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-8876
Practice Address - Country:US
Practice Address - Phone:801-569-2626
Practice Address - Fax:801-569-5333
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT171974-1205174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000055148OtherMEDICARE PAYER ID
UT000055148OtherMEDICARE PAYER ID
UTD07397Medicare UPIN