Provider Demographics
NPI:1568270296
Name:BARNES, BRIAN FRANKLIN
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:FRANKLIN
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 1:9714 PARKVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44104-4706
Mailing Address - Country:US
Mailing Address - Phone:216-307-8168
Mailing Address - Fax:
Practice Address - Street 1:9714 PARKVIEW AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44104-4706
Practice Address - Country:US
Practice Address - Phone:216-307-8168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC4494710405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes405300000XOther Service ProvidersPrevention Professional