Provider Demographics
NPI:1154765139
Name:BARNETT, BRADLEY POWERS (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:POWERS
Last Name:BARNETT
Suffix:
Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:3278 SOUTHERLAND RD
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-6212
Mailing Address - Country:US
Mailing Address - Phone:916-957-1515
Mailing Address - Fax:916-957-1567
Practice Address - Street 1:1111 EXPOSITION BLVD.
Practice Address - Street 2:BUILDING 200 SUITE 2000
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-4314
Practice Address - Country:US
Practice Address - Phone:916-957-1515
Practice Address - Fax:916-957-1567
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA154913207W00000X, 207WX0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS3488511Medicaid