Provider Demographics
NPI:1891763777
Name:BARBER, CHRISTOPHER BERNARD (IDC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:BERNARD
Last Name:BARBER
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:CHRISTOPHER
Other - Middle Name:BERNARD
Other - Last Name:BARBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:IDC
Mailing Address - Street 1:126 LAKE MANOR DR
Mailing Address - Street 2:
Mailing Address - City:KINGSLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31548-6274
Mailing Address - Country:US
Mailing Address - Phone:904-270-6515
Mailing Address - Fax:
Practice Address - Street 1:USS PHILIPPINE SEA
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AA
Practice Address - Zip Code:34092-1178
Practice Address - Country:US
Practice Address - Phone:902-270-6515
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman