Provider Demographics
NPI:1194097931
Name:BARNETT, DENNIS LEROY II (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:LEROY
Last Name:BARNETT
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1496 ST HELENS ST NW
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-2096
Mailing Address - Country:US
Mailing Address - Phone:503-509-3483
Mailing Address - Fax:715-804-8646
Practice Address - Street 1:6250 COMMERCIAL ST SE STE 100
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97306-2988
Practice Address - Country:US
Practice Address - Phone:503-436-6994
Practice Address - Fax:715-504-8646
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2022-11-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD181105207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500725506Medicaid