Individual
MARY LOIS BARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
115 WYOMING ST, LANDER, WY 82520-3919
(307) 332-2185
(307) 322-7799
Mailing address
115 WYOMING ST, LANDER, WY 82520-3919
(307) 332-2185
(307) 322-7799
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5773A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111667300
—
WY
01
—
295833
ALTIUS
WY
01
—
303923
BLUE CROSS
WY
05
—
504824210005
—
UT
Enumeration date
09/26/2006
Last updated
01/03/2012
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