Provider Demographics
NPI:1366423451
Name:BARNHART, JAMES ALLEN (OD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ALLEN
Last Name:BARNHART
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 1:2915 GEORGE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-9316
Mailing Address - Country:US
Mailing Address - Phone:989-345-7466
Mailing Address - Fax:989-345-1281
Practice Address - Street 1:304 W HOUGHTON AVE
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-1222
Practice Address - Country:US
Practice Address - Phone:989-345-2020
Practice Address - Fax:989-345-1281
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002684152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0356290001OtherMEDICARE DURABLE MEDICAL
MI5092892Medicaid
0356290001OtherMEDICARE DURABLE MEDICAL