Provider Demographics
NPI:1952285041
Name:BARNES, MARK ANTHONY
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:ANTHONY
Last Name:BARNES
Suffix:
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:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:LAKEMORE
Mailing Address - State:OH
Mailing Address - Zip Code:44250-0248
Mailing Address - Country:US
Mailing Address - Phone:330-256-0524
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 248
Practice Address - Street 2:
Practice Address - City:LAKEMORE
Practice Address - State:OH
Practice Address - Zip Code:44250-0248
Practice Address - Country:US
Practice Address - Phone:330-256-0524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-02
Last Update Date:2025-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications