Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 4849/T1714 | OH |
NPI | 1003898925 |
---|---|
Provider Name | Dr. Kimberley Renee Barnes |
First Address | Upper Sandusky, OH 43351-0540 |
Second Address | Upper Sandusky, OH 43351-1432 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 21/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2472837 | (05) | OH |
U86435 | (02) |