Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | S4598 | TX |
NPI | 1265828420 |
---|---|
Provider Name | David Barnes |
First Address | St George, UT 84790-8722 |
Second Address | St George, UT 84790-8722 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2015 |
Last Update Date | 28/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S4598 | TMB (01) | TX |