Provider Demographics
NPI:1750410841
Name:BARBER, ELAINE ADCOCK (MD)
Entity type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:ADCOCK
Last Name:BARBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 OAK LN
Mailing Address - Street 2:
Mailing Address - City:MOULTRIE
Mailing Address - State:GA
Mailing Address - Zip Code:31768-5458
Mailing Address - Country:US
Mailing Address - Phone:229-890-8068
Mailing Address - Fax:
Practice Address - Street 1:1414 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MOULTRIE
Practice Address - State:GA
Practice Address - Zip Code:31768-5812
Practice Address - Country:US
Practice Address - Phone:229-985-8713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA035812207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00512058AMedicaid
GA20BDBTCMedicare ID - Type UnspecifiedMEDICARE #
GAF36560Medicare UPIN