Provider Demographics
NPI:1831487917
Name:JAMES D BARBER OD LLC
Entity Type:Organization
Organization Name:JAMES D BARBER OD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:BARBER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-787-2400
Mailing Address - Street 1:5165 COOK ST NE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-6207
Mailing Address - Country:US
Mailing Address - Phone:770-787-2400
Mailing Address - Fax:770-787-4000
Practice Address - Street 1:5165 COOK ST NE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-6207
Practice Address - Country:US
Practice Address - Phone:770-787-2400
Practice Address - Fax:770-787-4000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-11
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1004-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU05532Medicare UPIN
GA202G709384Medicare PIN