Basic Information
| Provider Information | |||||||||
| NPI: | 1922267525 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARNES | ||||||||
| FirstName: | ANTOINETTE | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6626 E 75TH ST STE 500 | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462502890 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3176217588 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7120 CLEARVISTA DR | ||||||||
| Address2: | SUITE 2100 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462561621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3176212740 | ||||||||
| FaxNumber: | 3176215658 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2008 | ||||||||
| LastUpdateDate: | 05/21/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 010707370 | IN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 390200000X | 11013402A | IN | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208000000X | 01070370A | IN | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | P02198384 | 01 | IN | MEDICARE RR | OTHER | 201018890 | 05 | IN | MEDICAID | 201047970 | 05 | IN | MEDICAID |