Provider Demographics
NPI:1225161185
Name:BARNES, ROBERT JOSEPH (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:BARNES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 PONCE DE LEON AVE NE
Mailing Address - Street 2:SUITE 630A
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-1804
Mailing Address - Country:US
Mailing Address - Phone:404-897-5767
Mailing Address - Fax:404-897-3839
Practice Address - Street 1:650 PONCE DE LEON AVE NE
Practice Address - Street 2:SUITE 630A
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-1804
Practice Address - Country:US
Practice Address - Phone:404-897-5767
Practice Address - Fax:404-897-3839
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1371T152WC0802X
FLOP3080152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAMB0126260OtherDEA #
GA41ZCCMCMedicare ID - Type Unspecified
GAU49162Medicare UPIN