Provider Demographics
NPI:1356344055
Name:BARRIENTOS, BEATRIZ ALEXIA (MD)
Entity type:Individual
Prefix:DR
First Name:BEATRIZ
Middle Name:ALEXIA
Last Name:BARRIENTOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALEXIA
Other - Middle Name:
Other - Last Name:BARRIENTOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:P.O BOX 1758
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-3089
Mailing Address - Country:US
Mailing Address - Phone:706-854-2500
Mailing Address - Fax:706-854-2559
Practice Address - Street 1:411 TOWN PARK BLVD.
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3089
Practice Address - Country:US
Practice Address - Phone:706-854-2500
Practice Address - Fax:706-854-2559
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA053669174400000X, 208000000X
GA031554208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA039345492DMedicaid
GA039345492CMedicaid
GA039345492AMedicaid