Provider Demographics
NPI:1053564450
Name:KYLE BARNES, O.D., PLLC
Entity type:Organization
Organization Name:KYLE BARNES, O.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:859-255-6035
Mailing Address - Street 1:1063 E NEW CIRCLE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40505-4116
Mailing Address - Country:US
Mailing Address - Phone:859-255-6035
Mailing Address - Fax:859-225-9862
Practice Address - Street 1:1063 E NEW CIRCLE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505-4116
Practice Address - Country:US
Practice Address - Phone:859-255-6035
Practice Address - Fax:859-225-9862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1711DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty