Provider Demographics
NPI:1033100326
Name:MENCHAN, BARBARA LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:LYNN
Last Name:MENCHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BARBARA
Other - Middle Name:LYNN
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 117337
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-7337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2000 10TH AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-3700
Practice Address - Country:US
Practice Address - Phone:706-660-2932
Practice Address - Fax:706-660-2935
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0498782080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000922523DMedicaid