Individual
KELLIE BOYD BARNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
632 BROADWAY PH 12, NEW YORK, NY 10012-2614
(347) 294-3424
Mailing address
632 BROADWAY PH 12, NEW YORK, NY 10012-2614
(347) 294-3424
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35083658B
OH
207Q00000X
Family Medicine Physician
43055
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2458988
—
OH
05
—
64079031
—
KY
Enumeration date
04/25/2006
Last updated
09/22/2022
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