Provider Demographics
NPI:1770518045
Name:BARTH, GARIN DANIEL (MD)
Entity type:Individual
Prefix:MR
First Name:GARIN
Middle Name:DANIEL
Last Name:BARTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 WHITESVILLE ST
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30240-5903
Mailing Address - Country:US
Mailing Address - Phone:706-882-5119
Mailing Address - Fax:706-882-0270
Practice Address - Street 1:1605 WHITESVILLE ST
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30240-5903
Practice Address - Country:US
Practice Address - Phone:706-882-5119
Practice Address - Fax:706-882-0270
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA30949207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00391333EMedicaid
GA00391333EMedicaid
GA07BDCLVMedicare ID - Type Unspecified