Provider Demographics
NPI:1801973706
Name:BARR, NANCY S (OD)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:S
Last Name:BARR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301B PETROL PT
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-1552
Mailing Address - Country:US
Mailing Address - Phone:770-487-2020
Mailing Address - Fax:770-487-2720
Practice Address - Street 1:301B PETROL PT
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1552
Practice Address - Country:US
Practice Address - Phone:770-487-2020
Practice Address - Fax:770-487-2720
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA001040152WC0802X
GA1040152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA41ZCFKCMedicare ID - Type Unspecified
GAU20579Medicare UPIN