Provider Demographics
NPI:1063914448
Name:BARNHILL, KELVIN SR
Entity type:Individual
Prefix:MR
First Name:KELVIN
Middle Name:
Last Name:BARNHILL
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 N MORING AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27801-6243
Mailing Address - Country:US
Mailing Address - Phone:252-452-8572
Mailing Address - Fax:
Practice Address - Street 1:1621 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27801-6274
Practice Address - Country:US
Practice Address - Phone:252-454-8572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health