Individual
MR. CHARLES DEWAYNE BARNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1015 LANTON RD, WEST PLAINS, MO 65775-3854
(417) 256-2570
Mailing address
407 N 2ND ST, THAYER, MO 65791-1123
(870) 805-1286
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160759724
—
AR
Enumeration date
05/18/2015
Last updated
12/01/2016
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