Provider Demographics
NPI:1730479684
Name:BARNES, TAMMY S
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:S
Last Name:BARNES
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 1:3216 ETHEL AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906-1128
Mailing Address - Country:US
Mailing Address - Phone:706-580-6777
Mailing Address - Fax:706-653-8434
Practice Address - Street 1:3216 ETHEL AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-1128
Practice Address - Country:US
Practice Address - Phone:706-580-6777
Practice Address - Fax:706-653-8434
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1582172A00000X
AL9063172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver