Basic Information
| Provider Information | |||||||||
| NPI: | 1841693660 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BARNEY MEDICAL SPECIALIST LIMITED | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2810 W CHARLESTON BLVD | ||||||||
| Address2: | SUITE E-47 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891021921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028801558 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2810 W CHARLESTON BLVD | ||||||||
| Address2: | SUITE E-47 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891021921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028801558 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/07/2014 | ||||||||
| LastUpdateDate: | 10/07/2014 | ||||||||
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| AuthorizedOfficialLastName: | BARNEY | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7028801558 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 6980 | NV | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.