Provider Demographics
NPI:1760644603
Name:BARNEY, LEELA M (PA)
Entity Type:Individual
Prefix:MISS
First Name:LEELA
Middle Name:M
Last Name:BARNEY
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:547 PONCE DE LEON AVE NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-1880
Mailing Address - Country:US
Mailing Address - Phone:404-929-8824
Mailing Address - Fax:404-929-9769
Practice Address - Street 1:101 COMMERCE PL
Practice Address - Street 2:SUITE 1
Practice Address - City:BARNESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30204-1680
Practice Address - Country:US
Practice Address - Phone:770-358-4408
Practice Address - Fax:770-358-0002
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
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Provider Licenses
StateLicense IDTaxonomies
GAH800040207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000472128EMedicaid
GA000472128EMedicaid