Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | ||
Y | 222Z00000X | Podiatrist |
NPI | 1063653053 |
---|---|
Provider Name | Mr. Gary N Barnes |
First Address | Indianapolis, IN 46227-5122 |
Second Address | Indianapolis, IN 46227-5122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2009 |
Last Update Date | 20/03/2009 |