1083171045 NPI number — MRS. ARIANNA CURTIS BARTLESON MLS (ASCP)MT

Table of content: DR. FAISAL A SIDDIQUI M.D. (NPI 1902193402)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083171045 NPI number — MRS. ARIANNA CURTIS BARTLESON MLS (ASCP)MT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARTLESON
Provider First Name:
ARIANNA
Provider Middle Name:
CURTIS
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MLS (ASCP)MT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CURTIS
Provider Other First Name:
ARIANNA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1083171045
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/26/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1014 DURBAN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GROVETOWN
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30813-2243
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-490-1598
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1014 DURBAN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GROVETOWN
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30813-2243
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-490-1598
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/26/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 246QM0706X , with the licence number:  49448 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 246QM0706X , with the licence number: 260613 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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