Provider Demographics
NPI:1306405741
Name:BARNES, DYLAN MICHAELA KELLY (MD)
Entity type:Individual
Prefix:
First Name:DYLAN
Middle Name:MICHAELA KELLY
Last Name:BARNES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE STE 1200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3361
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4735 E 91ST ST STE 200
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-2806
Practice Address - Country:US
Practice Address - Phone:918-794-4788
Practice Address - Fax:918-794-4789
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA100448208C00000X
OK46026208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery