Provider Demographics
NPI:1285465559
Name:BARNES, NOAH DAVID
Entity type:Individual
Prefix:
First Name:NOAH
Middle Name:DAVID
Last Name:BARNES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8510 PLUM VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:SELLERSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47172-9051
Mailing Address - Country:US
Mailing Address - Phone:812-670-6767
Mailing Address - Fax:
Practice Address - Street 1:8510 PLUM VALLEY CT
Practice Address - Street 2:
Practice Address - City:SELLERSBURG
Practice Address - State:IN
Practice Address - Zip Code:47172-9051
Practice Address - Country:US
Practice Address - Phone:812-670-6767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN45023398A390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program