Provider Demographics
NPI:1134506793
Name:BARNES, GLENN (DO)
Entity type:Individual
Prefix:
First Name:GLENN
Middle Name:
Last Name:BARNES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:96 MISTY RAIN ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-5656
Mailing Address - Country:US
Mailing Address - Phone:702-234-5981
Mailing Address - Fax:702-359-5344
Practice Address - Street 1:3227 E WARM SPRINGS RD
Practice Address - Street 2:BLDG 23 SUITE 300
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120
Practice Address - Country:US
Practice Address - Phone:702-209-3590
Practice Address - Fax:702-359-5344
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-04
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVDO2246207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine