Individual
CHARLES E BARNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD PA
Contact information
Practice address
414A MARION AVE, MCCOMB, MS 39648-2710
(601) 684-6241
(601) 684-0280
Mailing address
PO BOX 688, MCCOMB, MS 39649-0688
(601) 684-6241
(601) 684-0280
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
531
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00880058
—
MS
01
—
1393509
MEDICAID
LA
Enumeration date
11/07/2006
Last updated
12/19/2024
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