Provider Demographics
NPI:1386960326
Name:REGINALD D. BARNES JR MD PC
Entity type:Organization
Organization Name:REGINALD D. BARNES JR MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:202-331-1754
Mailing Address - Street 1:2112 F ST NW
Mailing Address - Street 2:SUITE 802
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-2715
Mailing Address - Country:US
Mailing Address - Phone:202-331-1754
Mailing Address - Fax:202-331-1757
Practice Address - Street 1:2112 F ST NW
Practice Address - Street 2:SUITE 802
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2715
Practice Address - Country:US
Practice Address - Phone:202-331-1754
Practice Address - Fax:202-331-1757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD19770207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC023895300Medicaid
DC57554BMedicare UPIN
DC491446Medicare PIN