Provider Demographics
NPI:1265938716
Name:BARNES, JAMES MAURICE (CO/LO)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MAURICE
Last Name:BARNES
Suffix:
Gender:M
Credentials:CO/LO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6355 PEACHTREE DUNWOODY RD APT 309
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4627
Mailing Address - Country:US
Mailing Address - Phone:770-396-2243
Mailing Address - Fax:
Practice Address - Street 1:6355 PEACHTREE DUNWOODY RD APT 309
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4627
Practice Address - Country:US
Practice Address - Phone:770-396-2243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA123830222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist