Provider Demographics
NPI:1710636295
Name:BARRETT, DEVON
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:
Last Name:BARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 COLONIAL HOMES DR NW UNIT 2125
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1623
Mailing Address - Country:US
Mailing Address - Phone:973-634-6818
Mailing Address - Fax:
Practice Address - Street 1:1525 CLIFTON RD NE FL 3
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-2937
Practice Address - Country:US
Practice Address - Phone:404-778-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA13643207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology