Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 19056 | AL |
NPI | 1033168547 |
---|---|
Provider Name | Mack N Barnes |
First Address | Mountain Brk, AL 35223-2457 |
Second Address | Mountain Brk, AL 35223-2457 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 09/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000035900 | (05) | AL |
000035900 | BLUE CROSS (01) | AL |
009969135 | (05) | AL |
051524427 | BLUE CROSS (01) | AL |
051530003 | BLUE CROSS (01) | AL |
160043355 | RAILROAD MEDICARE (01) | AL |
G13158 | (02) | AL |
G13158 | HEALTHSPRING (01) | AL |
G13158 | VIVA (01) | AL |