Individual
WILLIAM MARK BARNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1605 MARTIN SPRINGS DR STE 210, ROLLA, MO 65401-2980
(573) 458-6326
(573) 458-6763
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 820-2000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2011018665
MO
207Q00000X
Family Medicine Physician
Primary
2014011573
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MO
Enumeration date
06/24/2011
Last updated
07/16/2014
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