Provider Demographics
NPI:1538162433
Name:BARNES, GARY THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:THOMAS
Last Name:BARNES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1100 E 3RD ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2201
Mailing Address - Country:US
Mailing Address - Phone:423-778-4800
Mailing Address - Fax:423-778-4801
Practice Address - Street 1:1100 E 3RD ST
Practice Address - Street 2:SUITE 102
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2201
Practice Address - Country:US
Practice Address - Phone:423-778-4800
Practice Address - Fax:423-778-4801
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2008-04-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNMD17883207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A99071Medicare UPIN