Basic Information
Provider Information
NPI: 1417958919
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARNES
FirstName: SETH
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3443 HARRISON ST
Address2:  
City: BATESVILLE
State: AR
PostalCode: 725018820
CountryCode: US
TelephoneNumber: 8706981635
FaxNumber: 8707933196
Practice Location
Address1: 1662 HIGDON FERRY RD STE 200
Address2:  
City: HOT SPRINGS
State: AR
PostalCode: 71913
CountryCode: US
TelephoneNumber: 5016232781
FaxNumber: 5016231774
Other Information
ProviderEnumerationDate: 08/09/2005
LastUpdateDate: 12/16/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/16/2019

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
174400000XE1934ARN Other Service ProvidersSpecialist 
207R00000XE-1934ARY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
13606900105AR MEDICAID


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