Provider Demographics
NPI:1083636351
Name:MCCOLLUM, BARBARA H (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:H
Last Name:MCCOLLUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:COLLEEN
Other - Last Name:HARVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:918 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-6198
Mailing Address - Country:US
Mailing Address - Phone:229-226-8800
Mailing Address - Fax:229-228-7005
Practice Address - Street 1:918 S BROAD ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-6198
Practice Address - Country:US
Practice Address - Phone:229-226-8800
Practice Address - Fax:229-228-7005
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA054621207V00000X, 207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA902911713DMedicaid
GA902911713CMedicaid
GA16BBDDKMedicare UPIN