Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223E0200X | Endodontist | 5038 | AZ |
Y | 1223G0001X | General Practice | 5038 | AZ |
Y | 213EG0000X | General Practice | 5038 | AZ |
NPI | 1104812775 |
---|---|
Provider Name | Dr. Brett M Barney |
First Address | Tucson, AZ 85747-9702 |
Second Address | Tucson, AZ 85747-9702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2005 |
Last Update Date | 02/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100-5038 | DELTA DENTAL (01) | AZ |
AZ 0490680 | BLUECROSS BLUESHIELD (01) | AZ |