Provider Demographics
NPI:1366881427
Name:BARNES, CODY JAMISON (MD)
Entity type:Individual
Prefix:DR
First Name:CODY
Middle Name:JAMISON
Last Name:BARNES
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Gender:M
Credentials:MD
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:CB 8109
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-747-2829
Mailing Address - Fax:314-362-5743
Practice Address - Street 1:4901 FOREST PARK AVE
Practice Address - Street 2:STE 420
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-1495
Practice Address - Country:US
Practice Address - Phone:314-747-2829
Practice Address - Fax:314-362-5743
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2023-01-17
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Provider Licenses
StateLicense IDTaxonomies
MO2018036776207LC0200X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200030660Medicaid