Provider Demographics
NPI:1518036920
Name:BARNES-O'GORMAN, SIDNEY J (DC)
Entity Type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:J
Last Name:BARNES-O'GORMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3155 ROSWELL RD NE STE 140
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1836
Mailing Address - Country:US
Mailing Address - Phone:404-231-1000
Mailing Address - Fax:404-231-5546
Practice Address - Street 1:3155 ROSWELL RD NE STE 140
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1836
Practice Address - Country:US
Practice Address - Phone:404-231-1000
Practice Address - Fax:404-231-5546
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO02094111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACHIRO02094OtherGA LICENSE
GACHIRO02094OtherGA LICENSE