Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 35043151 | OH |
N | 208D00000X | General Practice Physician | 35-043151 | OH |
NPI | 1033102918 |
---|---|
Provider Name | Mr. Robert E. Barnett |
First Address | Defiance, OH 43512-1336 |
Second Address | Defiance, OH 43512-1336 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2005 |
Last Update Date | 25/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000338203 | ANTHEM (01) | OH |
03142 | PHC (01) | OH |
0429521 | (05) | OH |
18-30177 | UHC (01) | OH |
4468179 | AETNA (01) | OH |
C01788 | (02) | OH |
P00158156 | RRMC (01) | OH |