Provider Demographics
NPI:1679665418
Name:STANCIL, BARBARA ELLEN COFER (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ELLEN COFER
Last Name:STANCIL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:BARBARA
Other - Middle Name:ELLEN
Other - Last Name:COFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:310 HIGH MEADOWS PL
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-8116
Mailing Address - Country:US
Mailing Address - Phone:478-494-5819
Mailing Address - Fax:
Practice Address - Street 1:1120 15TH ST
Practice Address - Street 2:BI 5092
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-0004
Practice Address - Country:US
Practice Address - Phone:706-721-2472
Practice Address - Fax:706-721-0211
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004820363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical