Basic Information
Provider Information
NPI: 1255591327
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARNES
FirstName: JOY
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 745 HASKINS RD
Address2: STE B
City: BOWLING GREEN
State: OH
PostalCode: 434021600
CountryCode: US
TelephoneNumber: 4193537069
FaxNumber: 4193537076
Practice Location
Address1: 3909 WOODLEY RD
Address2: SUITE 500
City: TOLEDO
State: OH
PostalCode: 436061169
CountryCode: US
TelephoneNumber: 4192912670
FaxNumber: 4194796999
Other Information
ProviderEnumerationDate: 06/12/2008
LastUpdateDate: 05/12/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X35.096902OHY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
005291405OH MEDICAID


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