# MARY LOIS BARNES

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1679674246
- **Gender:** F
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | 5773A | WY | Yes |

## Other

- **Enumeration date:** 09/26/2006
- **Last updated:** 01/03/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 111667300 | — | WY |
| 01 | — | 295833 | ALTIUS | WY |
| 01 | — | 303923 | BLUE CROSS | WY |
| 05 | — | 504824210005 | — | UT |