Basic Information
| Provider Information | |||||||||
| NPI: | 1770538738 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARNES | ||||||||
| FirstName: | EDWARD | ||||||||
| MiddleName: | KIRK | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 440100 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372440100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153290570 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3443 DICKERSON PIKE | ||||||||
| Address2: | STE 760 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372072519 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158601556 | ||||||||
| FaxNumber: | 6158601558 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2006 | ||||||||
| LastUpdateDate: | 02/27/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | 29751 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 4031220 | 01 | BCBS | OTHER | 830008090 | 01 | RAILROAD MEDICARE | OTHER | 7786338 | 01 | AETNA | OTHER | 3872752 | 05 | TN | MEDICAID | 64049976 | 05 | KY | MEDICAID |