Provider Demographics
NPI:1265435747
Name:BARNES, JEFF GUNNE ORTON (DO)
Entity type:Individual
Prefix:
First Name:JEFF
Middle Name:GUNNE ORTON
Last Name:BARNES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2520 E MAIN ST
Mailing Address - Street 2:STE 206
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332-4189
Mailing Address - Country:US
Mailing Address - Phone:361-664-4500
Mailing Address - Fax:361-664-4503
Practice Address - Street 1:2520 E MAIN ST
Practice Address - Street 2:STE. 206
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-4189
Practice Address - Country:US
Practice Address - Phone:361-664-4500
Practice Address - Fax:361-664-4503
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7856207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163134302Medicaid
TXOTHOQMedicare UPIN