Provider Demographics
NPI:1215102298
Name:BARNES, SCOTT RONALD (OD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:RONALD
Last Name:BARNES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:801-232-1242
Mailing Address - Fax:
Practice Address - Street 1:9720 S 1300 E STE E210
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-3779
Practice Address - Country:US
Practice Address - Phone:801-572-0631
Practice Address - Fax:801-572-0670
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT363114-9934152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management