Basic Information
| Provider Information | |||||||||
| NPI: | 1326247149 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BARNARD PLASTIC SURGERY, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2660 | ||||||||
| Address2: | |||||||||
| City: | WATERLOO | ||||||||
| State: | IA | ||||||||
| PostalCode: | 507042660 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2710 SAINT FRANCIS DR STE 310 | ||||||||
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| City: | WATERLOO | ||||||||
| State: | IA | ||||||||
| PostalCode: | 507025620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3192728488 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2007 | ||||||||
| LastUpdateDate: | 10/16/2008 | ||||||||
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| AuthorizedOfficialLastName: | BARNARD | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
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| AuthorizedOfficialTitleorPosition: | MD | ||||||||
| AuthorizedOfficialTelephone: | 3192333044 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.